W.P.C


 

APPLICATION FOR THE GRANT OF AN INDIAN AMATEUR W.T.LICENCE TO A FOREIGN NATIONAL

 

1.     

Name of applicant              

:

 

2.     

List other names (if any)

:

 

3.     

Date of birth                          

:

 

4.     

 

Place of birth (i.e. where your birth was recorded and nationality)

:

 

 

Father's name and home address

:

 

 

 

5.     

 

Present occupation (major work or profession for which you receive money or activity which occupies the majority of your time)     

:

 

6.     

Mailing address in your own country 

:

 

 

 

7.     

Indian address at which while you will receive mail while in India

:

 

 

8.     

Address to which you want the license mailed, if issued

:

 

 

 

9.     

a   Period of Proposed operation in India

:

 

 

b   Purpose of your visit to India

:

 

 

10.            

i    State Passport No.          

:

 

 

     Place where issued       

:

 

 

 

     Date of issue                   

:

 

 

     Date of expiration 

:

 

 

ii   If you have a Visa, state  type            

:

 

 

     Date of issue                   

:

 

 

     Date of expiration           

:

 

11.            

i.      License No. of Amateur Radio Operator  and Station License issued to you by your country

     (If possible enclose a Photostat copy)

:

 

 

ii    Expiration date of license

:

 

 

iii   Callsign                                

:

 

12.            

i Name of country which issued your   Amateur Radio License

:

 

 

ii Are you a citizen of that country?  

:

 

13.            

List of address of each location at which you will reside/operate in India

 

 

 

Location

 

Dates of stay

 

 

 

Beginning                                      Ending

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.            

Briefly describe your proposed itinerary / holidays while in India  

:

 

 

 

15.            

Particulars of previous applications if any made by the applicant for issue of Indian  Amateur licence    

:

 

16.            

Particulars of proposed apparatus to be used  

 

 

 

Transmitting 

:

 

 

Receiving

:

 

 

Aerials   

:

 

17.            

Frequency Bands desired to be used and types of modulations          

:

 

 


 

 

18.            

Please enclose personal description on a separate sheet of paper on the following points in triplicate.

 

1.    Name in full               

:

 

 

 

2.    Date of birth              

:

 

 

 

3.    Place of birth             

:

 

 

 

4.    Age                        

:

 

 

 

5.    Height                     

:

 

 

 

6.    Colour of eyes             

:

 

 

 

7.    Colour of hair             

:

 

 

 

8.    Complexion                 

:

 

 

 

9.    Any special particulars or marks                   

:

 

 

19.            

Enclose two passport size photographs signed and dated on the front.

 

 

 

 

 

Place :

 

 

Signature of applicant

 

Date  :

 

 

 


 

20.            

Declaration

 

        I undertake to observe the conditions of the licence and hereby certify that the apparatus herein described can and will be worked in accordance with the provisions of the Indian Wireless Telegraphy (Amateur Service) Rules, 1958.

 

 

Signature of applicant

 

Date:

 

21.            

Declaration To Observe Secrecy

         I,__________________________,do solemnly and sincerely declare that I will not, without authorisation, divulge to any person the purport of any message, other than a message intended for the general use of the public, which I may transmit or receive by means of any  radio-telegraph or radio-telephone apparatus operated by me or which may come to my knowledge in connection with the operation of the said apparatus.

                  

Place         : &nbs