SCOTIA
"ACTIVATOR" APPLICATION FORM
| This is an
INITIAL application :- |
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This is an
UPGRADE application :- |
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Activated Island(s)
(please complete in chronological order, and continue on a separate piece of paper if
activations of more than 50 islands are being claimed)
| No |
Ref |
Island Name |
Activation Date(s) |
| 1 |
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| 2 |
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| 3 |
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| 11 |
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| 13 |
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| 14 |
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| 15 |
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| 17 |
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| 18 |
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| 19 |
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| 21 |
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| 22 |
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| 23 |
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| 24 |
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| 25 |
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| No |
Ref |
Island Name |
Activation Date(s) |
| 26 |
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| 27 |
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| 28 |
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| 29 |
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| 30 |
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| 31 |
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| 32 |
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| 33 |
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| 34 |
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| 35 |
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| 36 |
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| 37 |
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| 38 |
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| 39 |
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| 40 |
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| 41 |
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| 42 |
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| 43 |
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| 44 |
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| 45 |
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| 46 |
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| 47 |
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| 48 |
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| 49 |
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| 50 |
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Previously Claimed Points |
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Calculation of BASIC and BONUS Points
(Please refer to the information on the Activators Point Page when completing this form)
| UK (excl. EIRE) ACTIVATORS -
BASIC & BONUS Points |
Each different Island Activated
(1 pt each) |
First time SCOTIA expedition to
ANY island
(10 points) |
Each first-time
Activation of CS or CN Group
[max 8 points]
(4 points each) |
Each other CS or CN Group
Island activated
(2 pts each) |
Each first-time
Activation of OI, DI, HI or SI Group [max 32]
(8 points each) |
Each other OI, DI, HI or SI
Group Island
activated
(4 pts each) |
Bonus per each clearly separate
'expedition'
(GM - 5 pts
Non-GM 10 pts) |
TOTAL POINTS CLAIMED |
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| ACTIVATORS Resident on Scottish Islands -
BASIC & BONUS Points |
Each different Island Activated
(1 pt each) |
First Activation of 'own'
SCOTIA Island [after 01/01/96]
(20 points) |
First Activation of any other
'own group' island
(4 points) |
Each activation of any other
'own group' island
(2 points each) |
First Activation of any other
island group
(8 pts, max 40) |
Each island
activated in other island groups
(4 points each) |
Bonus per 'expedition' outwith
'own' island group
(5 points each) |
TOTAL POINTS CLAIMED |
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| European (incl EIRE) and DX ACTIVATORS -
BASIC & BONUS Points |
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Each different Island Activated
(1pt each) |
First SCOTIA expedition
to ANY Scotia Island
(30 points) |
Each first-time
Activation of CS or CN Group
(8 or 12 points each) |
Each other CS or CN Group
Island activated
(4 or 6
points each) |
Each first-time
Activation of OI, DI, HI or SI Group
(16 or 24 points) |
Each other OI, DI, HI or SI
Group Island
activated
(8 or 12
points each) |
Each Return to Scotland to
activate any Scotia Island
(10 or 20
points per visit) |
TOTAL POINTS CLAIMED |
| EU |
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| DX |
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| CERTIFICATION |
Please
leave the space below blank |
I hereby certify the information I have
provided is, to the best of my knowledge, correct, and that I
| [a] |
have activated the above SCOTIA islands on
the dates stated,
and made the required minimum QSOs, (and I agree to submit any Logs , or copies, if
required); |
| [b] |
have operated within the terms and
conditions of my licence and any applicable reciprocal agreements; |
| [c] |
have obtained, where appropriate, prior
permission to land and to operate; |
| [d] |
have observed any requirements imposed by
the island owner(s) and have paid due regard for the environment; |
| [e] |
am willing, when requested by the Awards
Manager, to supply the name(s), address(es) and telephone number(s) of the person(s)
granting any such permission in [c], or limitations in [d] |
Signed : |
Date : |
Name (for certificate) :
(PLEASE PRINT CLEARLY) |
Callsign : |
Address :
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Post Code : |
| e-Mail Address : |
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| Date Rcvd. |
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| Payment Rcvd. |
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| Cert. No. |
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| ENDORSEMENTS |
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| Points Credited |
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| Cert. Sent |
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