Wisconsin VHF/UHF County Hunters Award Official Entry Form

County

Call

Date

Mode

50

144

222

432

903

1296

___

County

Call

Date

Mode

50

144

222

432

903

1296

_______

1

Adams

W9FZ/R

09/19/11

SSB

X

X

X

X

37

Marathon

KC9LWC

5/26/10

SSB

X

X*

X*

X*=W

9FZ/R

2

Ashland

AI9Z

06/11/11

SSB

X

38

Marinette

3

Barron

W9FZ/R

06/19/11

SSB

X

X

X

X

39

Marquette

WA9WGN

01/25/10

SSB

X

X

4

Bayfield

40

Menominee

W9FZ/R

06/13/11

SSB

X

5

Brown

N9OLT

06/15/11

SSB

X

41

Milwaukee

WB9TFH

6/3/10

SSB

X

6

Buffalo

W9FZ/R

06/16/11

SSB

X

X

X

X

42

Monroe

KC9NOJ/M

05/20/10

FM

X

7

Burnett

W9FZ/R

07/24/11

SSB

X

X

X

43

Oconto

W9FZ/R

06/13/11

SSB

X

X

8

Calumet

44

Oneida

W9FZ/R

07/17/11

SSB

X

X

9

Chippewa

N0EDV

06/13/10

SSB

X*

X

X*

*N9

ISN

45

Outagamie

W9FZ/R

06/12/11

SSB

X

X

10

Clark

W9FZ/R

07/17/11

SSB

x

X

x

X

46

Ozaukee

11

Columbia

09/21/10

W9FZ/R

SSB

X

47

Pepin

W9FZ/R

06/16/11

SSB

X

X

X

X

12

Crawford

WX9EP/M

8/19/10

FM

X

48

Pierce

W9FZ/R

6/15/11

SSB

X

X

X

X

13

Dane

N9LB

06/19/11

SSB

X

X

X

X

49

Polk

W9FZ/R/r

06/19/11

SSB

X

X

X

X

14

Dodge

K9AU

6/3/10

SSB

X

50

Portage

W9FZ/R

09/19/10

SSB

X

X

X

X

15

Door

51

Price

WB9WHQ

9/16/10

SSB

X

16

Douglas

AB9AC

07/19/11

FM

X

52

Racine

17

Dunn

W9FZ/R

06/19/11

SSB

X

X

X

X

53

Richland

W9FZ/R

9/16/10

SSB

X

X

X

X

18

Eau Claire

K9MU

01/23/10

SSB

X

X

X

X

54

Rock

19

Florence

W9FZ/R

07/16/11

SSB

X

55

Rusk

20

Fond du Lac

K9JCZ

4/14/10

SSB

X

56

Sauk

09/21/10

W9FZ/R

SSB

X

21

Forest

07/16/11

W9FZ/R

SSB

X

57

Sawyer

W9FZ/R

07/24/11

SSB

X

X

X

X

22

Grant

KC9MCC

8-19-10

FM

X

58

Shawano

W9FZ/R

06/13/11

SSB

X

X

X

23

Green

W9FZ/R

9/20/10

SSB

X

59

Sheboygan

KC9BQA

4/14/10

SSB

X

X

X

24

Green Lake

W9GA/w9fz/r

09/05-19/11

SSB

X

X

X

60

St Croix

W9FZ/R

06/19/10

SSB

X

X

X

X

25

Iowa

KE6CBR/R

9/20/10

SSB

X

61

Taylor

26

Iron

62

Trempealeau

N9UNW

1/24/10

FM

X

27

Jackson

N9PTZ

6/8/10

SSB

X

63

Vernon

W9FZ/R

1/24/10

SSB

X

X

X

X

28

Jefferson

64

Vilas

W9FZ/R

07/16/11

SSB

X

29

Juneau

N9PTZ/M

6/12/10

SSB

X

65

Walworth

K9KEU

7/29/10

SSB

X

30

Kenosha

66

Washburn

W9FZ/R

07/24/11

SSB

X

X

X

31

Kewaunee

W9BLI

07/18/10

SSB

X;

67

Washington

W9GA

06/13/10

SSB

X

X

X

X

32

La Crosse

W9RPM

6/12/11

SSB

X

X

X

X

68

Waukesha

33

Lafayette

W9FZ/R

9/20/10

SSB

X

69

Waupaca

W9FZ/M

7/28/10

SSB

X

34

Langlade

70

Waushara

W9FZ/M

7/28/10

SSB

X

35

Lincoln

W9FZ/R

07/16/11

SSB

X

X

X

X

71

Winnebago

W9FZ/M

7/28/10

SSB

X*

X

*=

K9IK

36

Manitowoc

W9FZ/R

06/11/11

SSB

X

X

X

72

Wood

WB9LYH

07/16/11

SSB

X

X

X*

*=W9

FZ/R

@

TOTAL

COLUMN

-

12

28

12

12

@

TOTAL

COLUMN

-

=

14

29

17

11

Check one only

Check one only

Initial Application (20 counties)

X

All Bands(6M-26,2M-57,1.25M-29,70M-23)

Endorsement Application (additional 10, 20, 30, or 40 counties)

Single Band Endorsement

Final Application (all 72 counties)

Email address

I affirm that I have observed all award rules. I certify that these contacts occurred as

indicated. I also agree to be bound by the decisions of the award manager and that all

Full Name

Call

Phone

such decisions are final.

Address

City

State

Zip

Applicant's Signature

Date