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Thank You For Reception Report
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https://forms.gle/KxeLVWfvMsRDBGtR7
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* Indicates required question
Email
*
Your email
Report Date
*
( DD MON YYYY) Eg: 10th Oct 2021 (Date Month in short name Year)
Your answer
Report Time
*
Your answer
Report Frequency
*
( in kHz)
Your answer
Report Reception
*
Reception : xxxx
Your answer
Report Receiver
Receiver : xxxx
Your answer
Antenna
(Antenna)
Your answer
Remarks
Condition, interference ( maximum 100 characters)
Your answer
Name
*
Your answer
Report person's Email
*
Your answer
Address
Your answer
City
*
Your answer
State
Your answer
Zip Code
Your answer
Country
*
Your answer
audio-file
Your answer
Send me a copy of my responses.
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