The Hawaii DX Association is an organization dedicated to recognizing those amateurs who have an interest in DX and have devoted their time and efforts in pursuing and improving DX as one of their hobbies in amateur radio. Membership is open to all

currently licensed amateur radio operators who have an interest in DX.

(Please Print)

NAME...................................................................CALL SIGN...........................

MAILING ADDRESS..........................................................................................

CITY AND STATE......................................................................ZIP..................

COUNTRY...........................E-MAIL................................PHONE.....................

DO YOU HAVE DXCC (ARRL) (YES/NO) WHAT TYPE................................

                                                                                            (Phone, CW, Mixed)

CERTIFICATE NO............................ CURRENT ARRL MEMBER (YES/NO)

HOW MANY COUNTRIES WORKED ? ...............CONFIRMED ? ................

SIGNATURE................................................................DATE............................

(HDXA Form 1, 1 Mar 2000)

MEMBERSHIP FEE  $5.00 for year 2000 (Rcv’d)...............DATE....................

(To be used for certificates/mailing/news info)