ARRL Special Events Application Form

Note: Submissions must be received by ARRL HQ no later than the 1st of the
second month preceding the publication date; ie, a Special Event listing for
Jan QST would have to be received by Nov 1. Send this completed form to:

ARRL 							Email: events@arrl.org
c/o Maty Weinberg 					Fax: 860-594-0259
225 Main Street					  (ARRL HQ, Attn: Special Events)
Newington, CT  06111


Town: ___________________________________________ State: _______________________

Sponsoring club or Organization:
______________________________________________________________________________

Call sign: ______________	Start Time (UTC): _________	Start Date: ______________

				End Time (UTC):  _________	End Date:  ______________

Short statement of event being commemorated (limit 60 characters):
______________________________________________________________________________

Four main (exact) frequencies (in MHz) to be used: (Note: expect to be within 20 kHz of these 
frequencies.)
_________________     _________________     __________________     __________________

Stations contacted may request a (check one):	Certificate _______	QSL _______

Name and address to QSL to:	______________________________________________________

				______________________________________________________

				______________________________________________________

Name, phone number and e-mail address of contact person:
______________________________________________________________________________

Note:  Because of QST page space limitations, we can carry only the Special
Event information as listed above as a free service to our members. If you wish 
to have additional information listed in QST, we suggest a Ham Ad. Ham Ads can 
carry information on your Special Event at a cost of only $1.00 a word, with a 
100 word limit, and will be published under the "Operating Activities" 
subheading. Copy for such Ham Ads must be received at ARRL HQ no later than 
three months before the date of your Special Event.