ARLHS Activator Award

Application Form

(Back to Award Rules)

The Amateur Radio Lighthouse Society (ARLHS) is the proud sponsor of the ARLHS Activator Award. Your signature on this application form confirms your reading, understanding and abiding by the ARLHS General Rules and Awards Requirements for this award. In the stations worked column please list two (2) stations that you worked from this lighthouse. For the ARLHS official list of lights and their ARLHS numbers, please see the "ARLHS Lighthouse Numbers" list.

 

No.
Call Used
Lighthouse Name
Stations Worked
Date
ARLHS
LH #
1
         
2
         
3
         
4
         
5
         
6
         
7
         
8
         
9
         
10
         

Name (printed) _______________________________________ Call Sign ______________

Address __________________________________________________________________

City ________________________________ State/Country _______________ Zip _______

E-mail ____________________________________ ARLHS Membership Number _______

Signature ____________________________________________ Date _________________

Enclose fees for certificate (US $2.00 for members; $5.00 for non-members) or endorsements ($2.00 each for USA applicants; $3.00 for DX).

Mail to: Award Manager: John Burnette, KF4ZLO, 2816 Timber Hills Rd, Louisville, KY 40214