10-10 Bar Awards Application

Please print your Name: ______________________________________ Call: ____________________

Address: __________________________________________________ Ten-Ten #: ________________

City: _____________________________________________________ State or Country: ___________

Postal Zip Code: ____________________________ E-mail Address: ________________________

Certificate or Bar applying for (Circle One)

100	200	300	400	500	600	700	800	900	1000
2500	5000	10000	12500	15000	17500	20000	22500	25000

Rules:

· All contacts must include call sign, name, QTH, and 10-10#. Cost is $2.00 USA and $3.00 for DX. Upgrades are SASE USA and $1.00 for DX. Please include your E-mail address, if you have one.

· Each bar application must contain exactly 100 contacts, each on a separate line showing 10-10 number, callsign, name state or country and date of contact.

· Contact dates are mandatory.

· Certificates, rather than endorsements, are available for levels 1000, 2500, 5000, 7500, 10,000 and every 2500 contacts thereafter.

· All applications must be submitted on the official forms available from the Award Manager or the 10-10 web site. A computer printout with the same information may be submitted in lieu of the official application.

· Entries for each application must be listed in ascending order of 10-10 numbers.

· A 10-10 number may be used only once in a bar award program. Only 5 errors are allowed on a bar application.

· QSL card confirmation is NOT required for the BAR award program.

· 10-10 award general rules and requirements are applicable.

DECLARATION:

By signing this application, I hereby certify that I have personally made contact with the Stations listed and the station listed gave me his

10-10 number during the contact. My logs Will be made available to the 10 -10 Bar program Manager if so requested.

I have enclosed a copy of my Membership Card, or address label from the latest copy of The 10-10 International News, showing my status as a paid up member of Ten-Ten.

Signature: ____________________________ Date: ____________

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10-10 Bar Awards Claim Sheet Worksheet

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10-10 Bar Awards Claim Sheet Worksheet

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