Cypress Chapter of 10-10 International

Applying for the Cypress Chapter is to be done using this form but you should read our Membership Page BEFORE you send this application off. Obtaining a Cypress Chapter membership number isn't all that difficult, but there are a couple of things you need to know before you submit this form.

You need to work 1 Instant Qualifier or 5 Cypress members who are not IQ's. Any Cypress member with a membership number of 1 through 1755, or 2007 through 2100 are Instant Qualifiers.

Cypress Chapter Online Application

Your Information:

Name: 

Call: (list ALL old calls or your application could be delayed)

10-10 #: 

Email: 

Certificate format:

 PDF - JPG
All certificate files are high resolution, PDF files allow you to print your certificate on your printer if you desire to do so. Should you desire to send your certificate to be printed at a photo center (such as WalMart®) then you will need a JPG file. You may select both formats if you so desire.

Note that all fields need to be filled in to complete your application for the Cypress Chapter certificate. Our form is set up to catch empty fields but cannot test for incorrect information such as typos so please be sure that all the information you enter into the form is correct. Pay special attention to your email address, if your email address is incorrect then we will not have any way to contact you regarding your application.

Your Ten-Ten International dues must be current, your 10-10 number will be verified to be sure your dues are current before memberships are granted.

Instant Qualifier Application Information

Their call:

Their 10-10#:

Their name:

Their QTH:

Their Cypress #:

Date you worked them:

Non - Instant Qualifier Application Information

Callsign

10-10 Number

Cypress #

Date Worked
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Page updated: November 14, 2007

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