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The Amateur Radio Lighthouse Society (ARLHS) is the proud sponsor of the Patriot Award. Your signature on this application form confirms your reading, understanding and abiding by the ARLHS General Rules and Awards Requirements for this award. The basic award will be issued for working and confirming at least one lighthouse in each of the original thirteen colonies of the United States. For the ARLHS official list of lights and their ARLHS numbers, please see the "ARLHS Lighthouse Numbers" list.
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State
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ARLHS
LH # |
Call
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Lighthouse Name
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Date
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OP's Name
(optional) |
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CT
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DE
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GA
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MD
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MA
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NH
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NJ
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NY
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NC
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PA
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RI
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SC
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VA
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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
ver Dec. 30 01