Expression of Interest Survey
qsl.org.za

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Contact Information:

E-mail address
First name & surname
Call sign
Address 1
Address 2
Address 3
Post code
Home phone number
Work phone number
Fax number
Cell number

Are you currently registered with QSL.NET?

Yes
No

Please indicate if you are prepared to pay for the service

Yes
No

If yes, what is the maximum amount you would be prepared to pay per year

Would you be prepared to be a donor/benefactor?

Yes
No

If yes, what amount would you be prepared to dondate

Other comments if any:

(This is not committment. It is simply an expression of interest.

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