Print this form out, fill it in and send to:
RADIO NEW ZEALAND INTERNATIONAL
PO Box 123
Wellington
New Zealand
If you would like us to send a QSL, then this report must be accompanied by two International Reply Coupons. Please don't send any cassettes.
| Date Heard (UTC) | |
| Time Heard (UTC) | |
| Frequency (kHz) | |
| Strength (circle one) | 5 Excellent | 4 Good | 3 Fair | 2 Poor | 1 Worthless |
| Interference | 5 None | 4 Slight | 3 Moderate | 2 Severe | 1 Extreme |
| Overall Merit | 5 Excellent | 4 Good | 3 Fair | 2 Poor | 1 Worthless |
| Receiver | |
| Antenna | |
| Programme Details |
|
| Your Name | |
| Your Address |
|