Call Sign: _____________________ Call: ____________________ Ten-Ten #: ____________________
State |
V P # |
Ten-Ten
# |
Call
|
Date
|
|
AK Alaska |
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AL
Alabama |
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AR
Arkansas |
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AZ
Arizona |
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CA
California |
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CO
Colorado |
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CT
Connecticut |
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DE
Delaware |
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FL
Florida |
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GA
Georgia |
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HI Hawaii |
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IA Iowa |
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ID Idaho |
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IL
Illinois |
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IN
Indiana |
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KS Kansas |
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KY
Kentucky |
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LA
Louisiana |
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MA
Massachusetts |
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MD
Maryland |
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ME Maine |
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MI
Michigan |
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MN
Minnesota |
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MO
Missouri |
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MS
Mississippi |
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MT
Montana |
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NC North
Carolina |
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ND North
Dakota |
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NE
Nebraska |
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NH New
Hampshire |
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NJ New
Jersey |
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NM New
Mexico |
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NV Nevada |
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NY New
York |
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OH Ohio |
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OK
Oklahoma |
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OR Oregon |
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PA
Pennsylvania |
|
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RI Rhode
Island |
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SC South
Carolina |
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SD South
Dakota |
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TN
Tennessee |
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TX Texas |
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UT Utah |
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VA
Virginia |
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VT
Vermont |
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WA
Washington |
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WI
Wisconsin |
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WY
Wyoming |
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WV West Virginia |
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Application for Ten-Ten VP WAS Award for (Name):
______________________________
Address: ____________________________ State or DX
Country:________________________
Zip Code:______________ Dues Expire:_______________ E-mail
Address:_________________
Signature:____________________________________ Date:_________________