Form Claim Award Paper :

Full Name
Your Callsign Amateur
Your Number Member in YB6-DXCommunity
Tulis alamat lengkap anda berikut RT/RW/Desa/Kecamatan ( Write your complete Pos Address )
City
Postal code
Please info LOTW password for our verification
I agree with the collection / storage of my entered data and IP for contact
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •