Application Form (html)

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="2" width=210 BGCOLOR="#9999FF" TEXT="#080000"> <div> <IMG SRC="061aba70.gif" border=0 width="171" height="167" ALT="Microsoft Photo Editor 3.0 Picture" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <bR> <bR> <bR> <div> <B>Please print out and send in completed form per</B></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Visitor Licence"><U><B>instructions</B></U></A></div> <bR> <bR> </td> <td valign="top" colspan=2 height=90 BGCOLOR="#99CCFF" TEXT="#080000" bgproperties="fixed" background="04176bc1egdyqn.gif"> <div> <FONT SIZE="5" COLOR="#FFFFCC" FACE="Arial" ><B>T.A.C.A.R.S.</B></FONT><FONT SIZE="2" COLOR="#0000CC" FACE="Times New Roman" ><B>   </B></FONT><B>|   </B><A HREF="index.htm" TARGET="_top" TITLE="T.A.C.A.R.S."><U><B>H</B></U></A><A HREF="index.htm" TARGET="_top" TITLE="T.A.C.A.R.S."><U><B>ome</B></U></A><B> |  </B><A HREF="id19.htm" TARGET="_top" TITLE="Visitor Licence"><U><B>How to get a Visitor Licence</B></U></A></div> <div>                                                   </div> <div> </div> </td> </tr><tr> <td valign="top" height=390 colspan=2 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> 8/01/2004</div> <bR> <div> <B>TURKS AND CAICOS ISLANDS</B></div> <div> <B>WIRELESS TELEGRAPHY ORDINANCE</B></div> <div> <B>APPLICATION FOR GRANT/RENEWAL* OF AN AMATEUR</B></div> <div> <B>RADIO OPERATOR LICENCE</B></div> <div> <B>Notes:</B></div> <div> 1. The application should be returned to Ministry of Communications (submitted by T.A.C.A.R.S.)</div> <div> 2. The applicant must hold a valid passport.</div> <div> 3. Every question must be answered even if the answer is in the negative</div> <div> 4. The prescribed application fee and all necessary documents must accompany this application</div> <div> 5. If you currently hold a valid licence it must be attached</div> <div> *Delete where inapplicable</div> <bR> <div> 1. Name of applicant_______________________________________Home Call_________________</div> <bR> <div> 2. Home address___________________________________________________________________</div> <bR> <div> 3. Telephone number__________________________E-mail ________________________________</div> <bR> <div> 4. Country of Birth____________________________Web Site (if any)_________________________</div> <bR> <div> 5. Citizenship______________________________________________________________________</div> <bR> <div> 6. Passport Number_________________________________________________________________</div> <bR> <div> 7. Apparatus Name/Model____________________________________________________________</div> <bR> <div> 8. Serial Number____________________________________________________________________</div> <bR> <div> 9. Base Station/Mobile Station*_________________________________________________________</div> <bR> <div> 10. Equipment will be normally kept at (Island)______________________________________________</div> <bR> <div> Address___________________________________________________________________________</div> <bR> <div> 11. Have you paid the licence fee________________Receipt No._______________________________</div> <bR> <div> 12. Are you a visitor______________Yes____________________No</div> <bR> <div> 13. If a visitor, how long will you need to hold the licence______________________________________</div> <bR> <div> 14. Do you currently hold a valid amateur radio licence__________Yes____________No</div> <bR> <div> 15. Person making application, if not the same as applicant___________________________________</div> <bR> <div> Dated_________________Signature of Applicant__________________________________________</div> <bR> <div> Dated_________________Authorized by T.A.C.A.R.S. Examiner_______________________________</div> <bR> <bR> <div> <B>For a Special Event Licence:</B></div> <div> I wish to apply for a Special Event Licence__________________ to operate during the______________</div> <div> ___________________________Contest during the period of ________________________________</div> <bR> <div> QSL Route Instructions<FONT SIZE="3" COLOR="#111111" FACE="Times-Roman" >___________________________________________</FONT><FONT SIZE="3" COLOR="#6633CC" FACE="Times-Roman" >______________</FONT></div> </td> </tr></table></body>