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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) |
