8/01/2004

TURKS AND CAICOS ISLANDS
WIRELESS TELEGRAPHY ORDINANCE
APPLICATION FOR GRANT/RENEWAL* OF AN AMATEUR
RADIO OPERATOR LICENCE
Notes:
1. The application should be returned to Ministry of Communications (submitted by T.A.C.A.R.S.)
2. The applicant must hold a valid passport.
3. Every question must be answered even if the answer is in the negative
4. The prescribed application fee and all necessary documents must accompany this application
5. If you currently hold a valid licence it must be attached
*Delete where inapplicable

1. Name of applicant_______________________________________Home Call_________________

2. Home address___________________________________________________________________

3. Telephone number__________________________E-mail ________________________________

4. Country of Birth____________________________Web Site (if any)_________________________

5. Citizenship______________________________________________________________________

6. Passport Number_________________________________________________________________

7. Apparatus Name/Model____________________________________________________________

8. Serial Number____________________________________________________________________

9. Base Station/Mobile Station*_________________________________________________________

10. Equipment will be normally kept at (Island)______________________________________________

Address___________________________________________________________________________

11. Have you paid the licence fee________________Receipt No._______________________________

12. Are you a visitor______________Yes____________________No

13. If a visitor, how long will you need to hold the licence______________________________________

14. Do you currently hold a valid amateur radio licence__________Yes____________No

15. Person making application, if not the same as applicant___________________________________

Dated_________________Signature of Applicant__________________________________________

Dated_________________Authorized by T.A.C.A.R.S. Examiner_______________________________


For a Special Event Licence:
I wish to apply for a Special Event Licence__________________ to operate during the______________
___________________________Contest during the period of ________________________________

QSL Route Instructions_________________________________________________________