FISTS SPRINT ENTRY FORM Entry Class QRO________ QRP_________ CLUB_________ SCORING: _______QSO points X _____multipliers = ________final score CLUB NAME__________________________________________________________ CLUB FISTS Number__________________________________________________ YOUR NAME_____________________________________ CALL________________ YOUR FISTS Number__________________________________________________ ADDRESS_____________________________________________________ ____________________________________________________________ Email Address(optional) __________________________________________ +---------------->>>>MULTIPLIER CHECK-OFF LIST<<<<-----------------+ | 1 2 3 4 5 6 7 8 9 0 VE DX | | CT NY DE AL AR CA AZ MI IL CO NB NF/LB | | MA NJ MD FL LA ID OH IN IA NS NT | | ME PA GA MS MT WV WI KS PE YK | | NH KY NM NV MN QC BC | | RI NC OK OR MO ON | | VT SC TX UT NE MB | | TN WA ND SK | | VA WY SD AB | +------------------------------------------------------------------+ Please enclose paper logs ONLY, photos, comments, ideas, etc., with your entry and mail promptly to: Dan Shepherd, N8IE 1900 Pittsfield St. Kettering, OH 45420 Statement:"I have observed all FISTS Sprint competition rules as well as all regulations for Amateur Radio in my country. My report is correct and true to the best of my knowledge. I agree to be bound by the decisions of the FISTS Awards Committee." Date ___________ Signature ________________________ Call ___________ COMMENTS: