Form C
THE RADIO AND TELEGRAPH CONTROL ACT, 1972
( Act 20 of 1972 )
APPLICATION FOR ALIEN AMATEUR RADIO STATION PERMIT
- Name (1)
…………………………………………………………………………
Surname Given Names
- Nationality (2)
………………………………………………………………….….
- Permanent Address In Home Country
………………………………………….…
………………………..……………………………………………………………
- Place Of Birth
………..……………………………………………………………
Date Of Birth
………………………………………………………………………
- Present Occupation (3)
…………………………………………………………….
Name Of Employer
……………………………………………………………..…
- Expected Date Of Arrival In Jamaica
………………………….……………………
Projected Date Of Departure From Jamaica
…………………..……………..…….
- Address While In Jamaica
………………………………………………………….
………………………..……………………………………………………………
- Passport or Travel Document Number
…………………..………………………….
- Amateur Radio Station License Number (4)
……………..………………………….
Date Of Issue
……………..………………………………………………………..
Date Of Expiration
..……………………..……………………….…………………
Call Sign
..……………..……………………………………………………………
.....………………...........………………………………….......…………….............
Signature Of Applicant
Date
…………..………..…………………..…………………………………………
Day Month Year
NOTES TO AID COMPLETION OF FORM C
Block Capitals or typewriter must be used to fill in the form
- The name to be entered must be shown in your passport.
Where no passport is available, proof of identity is required.
This is an essential requirement.
- If normally domiciled in a country other than that for which citizenship is claimed, a
valid passport must be produced as proof of citizenship.
- If self - employed, state name of company under which trade or profession is carried on,
if other than your own.
- A photocopy of the Amateur Radio Station License held must be forwarded with this
application.
- If your Amateur Station is to be operated at any place in Jamaica other than at the
address given for the period exceeding 48 hours, an itinerary showing projecting places
and dates must be given.