BUNDABERG AMATEUR RADIO CLUB: CLAIM FOR VHF/UHF DISTANCE RECORD

For Club Member Use Only

We want to make claiming a record as simple as possible but the following details should be provided so the committee can calculate an accurate distance;

CATEGORY you are entering ? (Home/Portable, Mobile, Handheld, ATV, Digital Mode, EME)
IF it's a 6 Metre Contact - Short or Long Path?
CONTACT: Date and Time ?

HOW MANY Kilometres are you claiming? ............................ (committee will attempt to verify this by coordinates, google earth etc)

STATION 1

Callsign:

Location: (physical location e.g. The Hummock)

If known, please include the: Latitude

& Longitude

STATION 2

Callsign:

Location: (physical location e.g. Bucca Pub)

If known, please include the: Latitude

& Longitude


Frequency:

Mode:

Any other Details relating to this Claim:

Operator's Name:

Postal Address:

Email address:


DECLARATION:
I hereby claim a new VHF-UHF Record for the contact described above. I declare that:
(a) To the best of my knowledge, the details given above are true and correct.
(b) At the time of the contact I was operating my station in accordance with the competition rules.
(c) I have read the Club's record claim conditions, and agree to accept the Committee's ruling on this
claim as final.


Signed:

Date:

To claim a record the above information must be supplied and emailed to BARC: rec3

And we know you can't 'sign' an email but we're asking for your word as gentlemen (and gentlewomen) that it's a legitimate claim, so just print your name.