Page:December 1915 QST.djvu/15

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APPLICATION BLANK


American Radio Relay League

Incorporated

Hartford, Connecticut


Your Name Address
(Street, City and State.)
Your Age Your Station Call Letters
Are you a member of any Radio or Wireless Club, and if so give its name and address:
Length of your Aerial Height above ground
Number of wires in Aerial and space between


SENDING EQUIPMENT

Do you obtain power from Batteries of City Current?
Do you use a Spark Coil or Transformer?
What is your Power Input?
Is your Spark Gap Rotary, Fixed or Quenched?
What Tone has your Spark? Approximate Wave Length
Give name and addresses of the FIVE most distant stations you communicate with:
State distance in miles
(OVER)