ZONE 29 Award - Application Form

Wireless Institute of Australia
Western Australian Division
Our Members are Important People, without you,
Our Organisation has No Purpose
ZONE 29 Award - Application Form

I submit herewith my application for the Zone 29 Award.

Please display on my Award Certificate, if successful, any special endorsement as
applicable to the rules and regulations for the Award. I enclose the required fee.
I declare that my station has been operated within the limitations of my amateur
radio licence for the contacts below.

Name (Please Print) ................................................................. Callsign ..............................

Address ................................................................................................................................

Address ..................................................................................... Post Code ........................

Signature ................................................................ Date of Application ...........................

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Certified by:

Name (Please Print) ............................................ Callsign ..........................
Name (Please Print) ............................................. Callsign ..........................

Applications should be addressed to:

ZONE 29 Award Manager
Western Australian Division, Wireless Institute of Australia
PO BOX 10, WEST PERTH, WESTERN AUSTRALIA 6872.

Rules .html Rules .doc Rules .pdf

Application Form .html Application Form .doc Application Form .pdf

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