Worked All Continents Application
Please print your Name: Call:
Address: Ten-Ten #:
City: State or Country:
Postal Zip Code: E-mail Address:
| Continent |
Call |
10-10 # |
Name |
QTH |
Date |
| Africa |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
| Asia |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
| Europe |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
| North America |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
| Oceania |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
| South America |
___________ |
___________ |
_______________ |
___________________________ |
__________ |
Send To:
Robert Camron - AJ5ZX
7641 Gladiola
San Angelo Tx 76901
email: AJ5ZX@cox.net
| Received |
QSL Cards |
Fee |
Award # |
Certificate Sent |
| _____________ |
_____________ |
_____________ |
_____________ |
_____________ |
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