Appalachian Trail Award    Log for the Trail Award

            Your Call ____________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

            Appalachian Trail Award    Log for the Trail Award

            Your Call ____________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

            Appalachian Trail Award    Log for the Trail Award

            Your Call ____________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

            Appalachian Trail Award    Log for the Trail Award

            Your Call ____________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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

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

              QTH worked _________________________________

              Your location on the Trail _______________________________________

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 __________________________________________