Application Mailing Address Citrus Belt Amateur Radio Club

P.O. Box 3788 San Bernardino, CA 92413

Route 66 On The Air 2020Application for Certificate

INSTRUCTIONS:  Please  fill  out  the  form  below  completely  and  accurately.  Then  along  with  your  US  $4.00 (USD) (Cash,  Check,  or  Money  Order)  made  payable to “C‐Bar‐C” or “Citrus Belt Amateur Radio Club” –  NO  Stamps  or  SASE’s  will  be  accepted  in  place  of  payment.  Mail  the  COMPLETED application  and  payment  to  the  below  address.  Return  Postage  and  all  supplies  will  be  provided  by  the  host.  Applications  will  only  be  accepted through the US Postal Service mail, NO online application submissions. PLEASE NOTE: CBARC NO LONGER ACCEPTS IRC'S.

NAME: CALL SIGN:

EMAIL: Fill in the log below. You must work at least ONE of the participating Route 66 On The Air stations in order to request the certificate.

STATION LOCATION DATE TIME (UTC)

BAND (MHZ) MODE

W6A SANTA MONICA, CA SEPTEMBER 2020 CW PHONE DIGITAL

W6B LOS ANGELES, CA SEPTEMBER 2020 CW PHONE DIGITAL

W6C SAN BERNARDINO, CA SEPTEMBER 2020 CW PHONE DIGITAL

W6D VICTORVILLE, CA SEPTEMBER 2020 CW PHONE DIGITAL

W6E BARSTOW, CA SEPTEMBER 2020 CW PHONE DIGITAL

W6F KINGMAN, AZ SEPTEMBER 2020 CW PHONE DIGITAL

W6G FLAGSTAFF, AZ SEPTEMBER 2020 CW PHONE DIGITAL

W6H ALBUQUERQUE, NM SEPTEMBER 2020 CW PHONE DIGITAL

W6I AMARILLO, TX SEPTEMBER 2020 CW PHONE DIGITAL

W6K OKLAHOMA CITY, OK SEPTEMBER 2020 CW PHONE DIGITAL

W6L TULSA, OK SEPTEMBER 2020 CW PHONE DIGITAL

W6M TRIBUNE, KS SEPTEMBER 2020 CW PHONE DIGITAL

W6N JOPLIN, MO SEPTEMBER 2020 CW PHONE DIGITAL

W6O LEBANON, MO SEPTEMBER 2020 CW PHONE DIGITAL

W6P ST. LOUIS, MO SEPTEMBER 2020 CW PHONE DIGITAL

W6Q CHICAGO, IL SEPTEMBER 2020 CW PHONE DIGITAL

W6R SPRINGFIELD, MO SEPTEMBER 2020 CW PHONE DIGITAL

W6U WILMINGTON, IL SEPTEMBER 2020 CW PHONE DIGITAL

ROVER STATIONS W6S ROVER 1 SEPTEMBER 2020 CW PHONE DIGITAL

W6T ROVER 2 SEPTEMBER 2020 CW PHONE DIGITAL

Please fill in your name and address. This will be the mailing label for your

certificate / decal.

5” x 5” LIMITED EDITION DECAL Decals are $5.00 each. Available in Red, White or Blue

RED @ WHITE @ BLUE @

Qty. x $ 5.00 each = $_ Qty. x $ 5.00 each = $_ Qty. x $ 5.00 each = $_

Decal Total $_

If you work a local repeater participating in the Route 66 On The Air event please provide the following Event Call Sign: Repeater Frequency: City: Date: September 2020 Time: UTC

W6J STROUD, OK SEPTEMBER 2020 CW PHONE DIGITAL W6J

information

W6A