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         60ºPARALELL NORTH AWARD 
 60ºParalell North Award      
        Application Name_____________________________________________________________________________ {As
        you would like it to appear on award}  Address___________________________________________________________________________
         Postal
        code_________________________
        City____________________________________________  Country____________________________________________________________________________
         Phone____________________
        EMail____________________ CALLSIGN______________________ Log 
 | STATION | DATE | TIME UTC | BAND | MODE | RST | QTH | |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| 
 I certify, on my honor, that have observed all regulations established for amateur radio in my country as well as the award rules. _______________________________________ Operator 
 We certify, that all QSL's have been checked and found true and correct in accordance with log. 
 
 ________________________________________ Two Names and Callsigns Award Manager Representative Cost
        of the award € 5,00 or 10 IRC’s 
        is $12 US Send
        application, prefix list, certification statement, and payment to:  Manuel
        Alberto C. Marques (CT1BWW) E-Mail
        – ct1bww @ cwhamradio.com 
 
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