|
This form is suspended due to
SPAM. Contact N4KIT direct.
(n4kit @
wt4ra.org)
Using Microsoft Internet
Explorer version 6.0 or later will give best
results. |
| Bold fields are
required |
|
Your
Name: |
|
|
Present license
class: |
|
|
CSCE credit: |
|
|
Call sign (if applicable): |
Which exam do you plan to take?
Check any or all that may apply
* |
|
Element 2: |
(Tech written) |
|
Element 3: |
(General written) |
|
Element 4: |
(Amateur Extra written) |
|
Address: |
|
|
Address (cont): |
|
|
City: |
|
|
State: |
|
|
Zip / Postal
Code: |
|
|
Daytime
phone: |
|
|
Evening phone: |
|
|
Fax: |
|
|
Email: |
|
|
Session
date: |
|
|
Comments: |
* Test element 2 = Unlicensed to
Tech. Element 3 = Tech to General upgrade. Element 3+4 =
Tech to Extra upgrade. Element
2+3+4 = Unlicensed to Extra. Element 4 = General or Advanced
to Extra upgrade.
|
| |
