4TH OF JULY-THE ORIGINAL 13 COLONIES
SPECIAL EVENT

STATE	CALL	DATE	UTC	BAND

NY      __________   ________  ________  ________

SC      __________   ________  ________  ________

VA      __________   ________  ________  ________

RI      __________   ________  ________  ________

CT      __________   ________  ________  ________

DE      __________   ________  ________  ________

GA      __________   ________  ________  ________

MD      __________   ________  ________  ________

MA      __________   ________  ________  ________

NJ      __________   ________  ________  ________

NC      __________   ________  ________  ________

NH      __________   ________  ________  ________

PA      __________   ________  ________  ________


YOUR CALL: _______________   NAME: _________________________

STREET ADDRESS: _______________________________________________

CITY:________________________ STATE:_____   ZIP:__________________

E-MAIL:___________________________________________________________

SEND TO:
KU2US-AWARD MGR.
PO BOX 185
CONESUS, NY 14435

Enclose Cash, Check or Money Order for $4.00 in U.S. Funds
MAKE CHECK or M.O  PAYABLE TO: Ken Villone-KU2US Awards Manager