Registration for VE Test

 
Please check the test elements you wish to take:

      ___  Element 2 – Technician
      ___  Element 3 – General
      ___  Element 4 – Extra
 

Name
 

   
Address
 		    
 
 		    
Telephone
 		    
Email
 		    
Call Sign
  		   
Class
 		    

Send To:

     John Bucsek, KE7WNB
       PO Box 230216
       Portland, OR 97281-0216

The Pre-Registration form
must be received by .

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