Appalachian Trail Award    Log for the Deluxe Award

            Your Call ____________

CT        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail _______________________________________

GA        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

MA        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

ME        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

MD        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

            Appalachian Trail Award    Log for the Deluxe Award

            Your Call ____________

NC        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

NH        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

NJ        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

NY        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

PA        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

            Appalachian Trail Award    Log for the Deluxe Award

            Your Call ____________

TN        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

VA        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail ________________________________________

VT        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail _________________________________________

WV        Call _________    Date ___/___/____    Time ____:____ UTC    Band ____

              RS(T) Sent ____        RS(T) Rcvd ____

              Their location on the Trail _________________________________________

            Appalachian Trail Award    Log for the Deluxe Award

            Your Call ____________

Name ______________________________________________    Call ________________

Address __________________________________________________________________

City ________________________________________________

State _____    Zip Code _________-______

"I have observed all Appalachian Trail Award rules as well as all regulations for Amateur Radio in my country. My report is correct and true to the best of my knowledge. I agree to be bound by the decisions of the Eastern PA QRP Club Committee"

Date ___/___/____    Signature __________________________________________