100 Years of Amateur Radio In Ballarat
Collecting information to Support Issue of Certificate;
 
Email address is collected only to enable sending of the Certificate.
You do *NOT* have to signin.
Do *NOT*  provide any passwords. .


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Callsign of Station to receive certificate
(if SWL report, enter other station callsign)
Station Operator given Name
Email address to receive Certificate
Date of QSO *only contacts between June to December 2023 are valid*
MM
/
DD
/
YYYY

Callsign of Ballarat Station

Band/Mode
Request entered by Callsign/Name
This could be a Ballarat Station confirming a QSO & entering data on behalf of a certificate recipient or
a station claiming a contact with a Ballarat station.

If SWL reporting a QSO heard
please enter the callsigns of both stations at "Callsign of Ballarat Station" and 

"Callsign of Station to receive certificate" 

and their own name at "Station Operator given name" prefixed with " SWL"



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