Application for 10-10 Counties Award

Date: 						 Basic Award: #				  Upgrade to: 		#	

Name: 															

Address: 					  City: 				 State: 		 Zip Code: 		

Country: 														

Call: 					 10-10 #: 				 Expiration: 				

Ex-Calls (optional): 			 E-Mail Address (optional): 							

**NOTE: Each Counties application must contain exactly 100 contacts. List each contact on a separate line and alphabetically by state and then by county. QSL confirmation is NOT required.

Mail To:
COUNTIES AWARD MANAGER
Mark Murphy KC4HIT 57448
PO Box 936,
Conover, NC 28613

E-mail kc4hit@gmail.com

Effective - August 1, 2023

© Copyright 2008 - 2023 10-10 International.

Page 1

10-10 Counties Awards Claim Worksheet

County #	Call Sign	Ten-Ten #	Name	County	Date	
1						
2						
3						
4						
5						
6						
7						
8						
9						
10						
11						
12						
13						
14						
15						
16						
17						
18						
19						
20						
21						
22						
23						
24						
25						

Page 2

10-10 Counties Awards Claim Worksheet

County #	Call Sign	Ten-Ten #	Name	County	Date	
26						
27						
28						
29						
30						
31						
32						
33						
34						
35						
36						
37						
38						
39						
40						
41						
42						
43						
44						
45						
46						
47						
48						
49						
50						

Page 3

10-10 Counties Awards Claim Worksheet

County #	Call Sign	Ten-Ten #	Name	County	Date	
51						
52						
53						
54						
55						
56						
57						
58						
59						
60						
61						
62						
63						
64						
65						
66						
67						
68						
69						
70						
71						
72						
73						
74						
75						

Page 4

10-10 Counties Awards Claim Worksheet
County #	Call Sign	Ten-Ten #	Name	County	Date	
76						
77						
78						
79						
80						
81						
82						
83						
84						
85						
86						
87						
88						
89						
90						
91						
92						
93						
94						
95						
96						
97						
98						
99						
100						

Just in Case
County #	Call Sign	Ten-Ten #	Name	County	Date	
Spare						
Spare						

Page 5

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