Welcome to 10-10 International

COUNTIES AWARD APPLICATION

Date:                                                                 Basic Award: #                                       Up Grade to:                #         

Name:                                                                                                                                                                          

Address:                                                             City:                                        State:               Zip Code:                    

Country:                                                                                                                                                                       

Call:                                                       10-10 #:                                                Expiration:                                           

Ex-Calls (optional):                                  E-Mail Address (optional):                                                                                 

**NOTE: Each Counties application must contain exactly 100 contacts. List each contact on a separate line and alphabetically by state and then by county. QSL confirmation is NOT required.

Have you included a copy of your Membership Card, $2.00 US & $3.00 DX for Basic, SASE US & $1.00 DX for upgrades Thank you for your participation in the 10-10 Award Program.

Mail To:
COUNTIES AWARD MANAGER
Brad Kimble - KØDBK #55192
3855 66th Street,
Iver Grove Heights, MN 55076-2222

E-mail k0dbk@comcast.net

Effective - January 1, 2000

County #

Call Sign

Ten-Ten #

Name

County

Date

1

 

 

 

 

 

2

 

 

 

 

 

3

 

 

 

 

 

4

 

 

 

 

 

5

 

 

 

 

 

6

 

 

 

 

 

7

 

 

 

 

 

8

 

 

 

 

 

9

 

 

 

 

 

10

 

 

 

 

 

11

 

 

 

 

 

12

 

 

 

 

 

13

 

 

 

 

 

14

 

 

 

 

 

15

 

 

 

 

 

16

 

 

 

 

 

17

 

 

 

 

 

18

 

 

 

 

 

19

 

 

 

 

 

20

 

 

 

 

 

21

 

 

 

 

 

22

 

 

 

 

 

23

 

 

 

 

 

24

 

 

 

 

 

25

 

 

 

 

 

 

County #

Call Sign

Ten-Ten #

Name

County

Date

26

 

 

 

 

 

27

 

 

 

 

 

28

 

 

 

 

 

29

 

 

 

 

 

30

 

 

 

 

 

31

 

 

 

 

 

32

 

 

 

 

 

33

 

 

 

 

 

34

 

 

 

 

 

35

 

 

 

 

 

36

 

 

 

 

 

37

 

 

 

 

 

38

 

 

 

 

 

39

 

 

 

 

 

40

 

 

 

 

 

41

 

 

 

 

 

42

 

 

 

 

 

43

 

 

 

 

 

44

 

 

 

 

 

45

 

 

 

 

 

46

 

 

 

 

 

47

 

 

 

 

 

48

 

 

 

 

 

49

 

 

 

 

 

50

 

 

 

 

 

 

County #

Call Sign

Ten-Ten #

Name

County

Date

51

 

 

 

 

 

52

 

 

 

 

 

53

 

 

 

 

 

54

 

 

 

 

 

55

 

 

 

 

 

56

 

 

 

 

 

57

 

 

 

 

 

58

 

 

 

 

 

59

 

 

 

 

 

60

 

 

 

 

 

61

 

 

 

 

 

62

 

 

 

 

 

63

 

 

 

 

 

64

 

 

 

 

 

65

 

 

 

 

 

66

 

 

 

 

 

67

 

 

 

 

 

68

 

 

 

 

 

69

 

 

 

 

 

70

 

 

 

 

 

71

 

 

 

 

 

72

 

 

 

 

 

73

 

 

 

 

 

74

 

 

 

 

 

75

 

 

 

 

 

 

County #

Call Sign

Ten-Ten #

Name

County

Date

76

 

 

 

 

 

77

 

 

 

 

 

78

 

 

 

 

 

79

 

 

 

 

 

80

 

 

 

 

 

81

 

 

 

 

 

82

 

 

 

 

 

83

 

 

 

 

 

84

 

 

 

 

 

85

 

 

 

 

 

86

 

 

 

 

 

87

 

 

 

 

 

88

 

 

 

 

 

89

 

 

 

 

 

90

 

 

 

 

 

91

 

 

 

 

 

92

 

 

 

 

 

93

 

 

 

 

 

94

 

 

 

 

 

95

 

 

 

 

 

96

 

 

 

 

 

97

 

 

 

 

 

98

 

 

 

 

 

99

 

 

 

 

 

100

 

 

 

 

 

Just in Case


County #

Call Sign

Ten-Ten #

Name

County

Date

Spare

 

 

 

 

 

Spare

 

 

 

 

 

 

© Copyright 2008 10-10 International.