Scout Award Membership Application

Scouts on Ten Award Application

For Member who are not Scouts, Previous Scouts, or Scout Leaders

Ten-Ten International Net, Inc.

Once this form is completed it will be sent to the Scout Awards Manager who will contact you with your Award information. You must be a member of Ten Ten and your membership must be current to apply. Club stations do not qualify.

All Fields Required

Name:	Callsign:
Address:	Ten Ten Number:
City:	State or Country:
Postal/Zip Code:	Email Address:

You must contact 10 Ten Ten members on 10 meters that have an S as a suffix on their Scout number.
All contacts must be after January 1 2016

	Call	Name	Ten Ten	Scout	Qth
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