NCVEC - One by One Request Form

NCVEC : 1x1 Call Signs : One by One Request Form

Tuesday, December 2, 2008

One by One Request Form

Instructions:
1. Be sure to read the NCVEC FAQ for guidelines about this form.
2. Fill out form below.
3. Review Final Page and Submit

Reserve 1x1 Call Sign:

Coordinator:

Beginning Date:
Date of planned Special Event Operation

Ending Date:
If more than 15 days contact coordinator first

Name of Event:
Ex: Memorial Dedication, ARC Field Day

Name or Name + Club Station Name:
As it appears on operator license

Current Call Sign / Club Call Sign:
As it appears on operator license

Current Mailing Address:
As it appears on operator license
Do not include your city, state, or zip
in this field.

City:
As it appears on operator license

State:
As it appears on operator license

Zip Code:
As it appears on operator license

Email Address:
Ex: mail@domain.com One email address only.

Daytime Phone:
Ex: (817) 555-1234 - do not leave your area code blank

Event Description / Additional Comments:
Describe the event and add additional comments for the coordinator if needed.