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ARKAN Worked All-Arkansas Award Work Sheet

To qualify for the Worked All-Arkansas Award, a station must have written verification of QSOs -- any band or mode -- with all 75 counties of the state of Arkansas. Please fill in the application sheet below, and return the completed application plus a $5.00 award certificate fee to: ARKAN, P.O. Box 9701, Fayetteville, AR, 72703. All applications must be verified and signed off by two current officers of a registered ARRL club, or by presentation of cards with form. If sending cards, please include return postage.

COUNTY CALL TOWN BAND COUNTY CALL

TOWN

BAND

ARKANSAS ASHLEY BAXTER BENTON BOONE BRADLEY CALHOUN CARROLL CHICOT CLARK CLAY CLEBURNE CLEVELAND COLUMBIA CONWAY CRAIGHEAD CRAWFORD CRITTENDEN CROSS DALLAS DESHA DREW FAULKNER FRANKLIN FULTON GARLAND GRANT GREENE HEMPSTEAD HOT SPRING HOWARD INDEPENDENCE IZARD JACKSON JEFFERSON JOHNSON LAFAYETTE

LAWRENCE LEE LINCOLN LITTLE RIVER LOGAN LONOKE MADISON MARION MILLER MISSISSIPPI MONROE MONTGOMERY NEVADA NEWTON OUACHITA PERRY PHILLIPS PIKE POINSETT POLK POPE PRAIRIE PULASKI RANDOLPH ST. FRANCIS SALINE SCOTT SEARCY SEBASTIAN SEVIER SHARP STONE UNION VAN BUREN WASHINGTON WHITE WOODRUFF YELL

I certify the contacts listed above as correct by visual inspection of the confirmed written QSOs, and I am a duly elected Ark. ARRL club officer.

#1 PRINT NAME:

CLUB:

SIGNATURE:

DATE:

#2 PRINT NAME:

CLUB:

SIGNATURE:

DATE:

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