2015 Field Day Entry Form - Test Mode
2015 Rules
Complete this form and click on the Submit button at the bottom of the page to submit your 2015 Field Day entry to the ARRL for review and tabulation. You can access a help page by clicking on the ? next to an item on the form.

Call Used ?     GOTA Station Call ?     ARRL/RAC Section

Club or Group Name (Class A, B or F only) ?

Number of Participants ?     Number of Transmitters in simultaneous operation ?

Entry Class (check only one):
A. Club or non-club group portable ?
B. 1 or 2 person non-club group portable ?     List calls of operators  
C. Mobile ?
D. Home station commercial power ?
E. Home station emergency power ?
F. EOC Station ?

Power Source (check all that apply):
Generator   Commercial mains   Battery   Solar   Other (list)

Power Multiplier (check only one):
5 Watts or less and Battery powered = 5  
150 Watts or less = 2
Over 150 Watts = 1

Bonus Points claimed: Check each box as appropriate and include required proof of points with your submission. All bonus points will be verified at ARRL HQ and added to your score.
100% Emergency power ?
Media Publicity ?
Set-up in Public Place ?
Information Booth ?
Formal message to ARRL SM/SEC ?
W1AW Field Day Message ?
Formal messages handled ? — No.
Natural power QSOs completed ?
Site Visit by invited elected official ?
Site Visit by invited served agency official ?
Youth participation ?
Number of youth participants who completed at least 1 QSO: 
Total number of youth participants:
Educational activity ?
Note: Bonus points for satellite QSO, GOTA QSOs and web submission will be automatically determined from info entered elsewhere on this form.
      Band/Mode QSO Breakdown: ?
  QSOs Pwr(W) QSOs Pwr(W) QSOs Pwr(W)

For GOTA Bonus, list names, calls and number of QSOs for each GOTA station operator: ?   Check for GOTA coach extra credit ?
Name Call QSOs Pwr(W) QSOs Pwr(W) QSOs Pwr(W)

I/We have observed all competition rules as well as all regulations for amateur radio in my/our country. My/our report is correct and true to the best of my/our knowledge. I/We agree to be bound by the decisions of the ARRL Awards Committee. Submission of this form indicates my/our agreement with these statements. ?

Name     Call     E-mail Address

Mailing address:

Comments/Additional Explanation:

Are you submitting supporting documentation to the ARRL as part of your entry: Yes   No
If yes, check method of submission: E-mail to: fieldday[at]arrl[dot]org
 Mail to: Field Day, ARRL, 225 Main St., Newington, CT 06111 USA



Version: 1.22
Revision Date: June 10, 2015
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