Traffic Test Entry

Please provide the information below for this message, and click Submit.

Traffic Test ID:
Message Number:
Station of Origin:

I'm reporting that this message was:

Fields marked with a * are required.

Radiogram Preamble and Address

Please compare the information below with the message you received, and make any changes to reflect the actual preamble and address as received.

Preamble

Number:
Precedence:
HX:
Station of Origin:
Check:
Place of Origin:
Date Filed (UTC):
Time Filed (UTC):

Address

Name:
Address Line 1:
Address Line 2:
City:
State/Province:
ZIP/PostalCode:
Telephone:
E-Mail:
Address OpNote:

Relay/Delivery Information

In this section, please record the relay or delivery of this test message.

Received

From Callsign *:
Date (UTC) *:
Time (UTC) *: 
Net Name *:
Band *:
Mode:

Radiogram Origination

Sent

To Callsign *:
Date (UTC) *:
Time (UTC) *: 
Net Name *:
Band *:
Mode *:

Delivered

Date (UTC) *:
Time (UTC) *:

Delivery Notes:

Did you receive a request to upload a copy of this test message?

Yes

Message text, as received *:

Signature, as received *:

Signature Op Note (if any), as received: