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Application For Amateur Radio (Intermediate) Licence A or B

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Please note: This form should be printed out and sent via 'surface mail' to the address given below. Please do not attempt to re-send this form via E-mail as we cannot at present handle electronic submisions.


Please print entire document.

RA165 is also available in pdf logo

Please refer to the notes below and complete in dark ink in BLOCK CAPITALS

Details of applicant

Name
(Title. Initials. Surname.)
Mailing address

Postcode
Telephone
(Please include dialing code)
Home

Work

Date of birth

 

Main station address (if different from mailing address)

Address

Postcode

 

Licence details

Type of licence required A B
Previous callsign
If you are applying for a Class A novice licence and you have held a Class B full licence please give your Class B full callsign.
Date of issue
Qualifications
(tick those that apply)

(please send originals as photocopies are not acceptable)

Course completion slip (NLTC)

Pass in NRAE

Pass in 5 or 12 wpm Morse Test

Holder of Class B full licence for 1 year

 

Callsign


If you would like to request a particular callsign, please provide details below. If you do not want to request a callsign you will be automatically allocated one by the system. (see notes below)

Callsign

 

Call books


Do you wish your name and address to be published?
(see notes below)

Yes No

 

Renewal payments


In future I wish to pay my renewal fee by:

Direct debit
Cheque/postal order/credit card/debit card

If you select to pay by Direct Debit a bank payment instruction will be sent to you.
(see notes below)

 

Declaration


If you provide false information you may invalidate your application and be liable for prosecution. I certify that the information I have given is correct to the best of my knowledge.

Name
Signed (Applicant) ........................................................
Date

If you are under 18 years of age the signature of your parent or guardian is required.

Signed
(Parent or Guardian)
........................................................
Date

 

Notes

Conditions

Under the Wireless Telegraphy Act 1949 a licence issued by the Secretary of State is required before any person may establish or use any station for wireless telegraphy or install or use any apparatus for wireless telegraphy in the UK and UK territorial waters.

To be eligible for a Class B Amateur Radio (Novice) Licence you must:

For a Class A Amateur (Novice) Licence you must

Publication of name and mailing address

The Radiocommunications Agency permits publication of your name and mailing address in a call book, if you have consented by ticking the appropriate box.

If you have not consented, only your callsign will be published. If this call book is compiled, stored and published by a third party, either in written form or by "read only" computer disks, it will be made clear to the third party that the information will be disclosed to it for the publication of a call book and for no other purpose.

Renewal payments

Please note that Licences are free to the under 21's and from 1 April 2001 to those aged 75 years or older. If you are under 21 or 75 and over at the time of renewal, you only need to sign and return the Remittance Advice Note to indicate that you wish to continue.

Requesting a callsign

If you would like to request a particular callsign in the current series of callsigns, you may do so at the callsign section overleaf. Before filling this in, you should telephone RLC to check that the callsign is available. The callsign will only be issued to you once your full application is received by them and callsigns are issued on a "first come first served" basis. Please note that if you previously held a callsign, this will be re-issued to you and you will not be able to request another callsign.

How to pay

Please enclose a cheque or Postal Order for the fee valid at the time of application made payable to Radio Licensing Centre and crossed "A/C Payee". Please print your name and customer reference number on the reverse of your cheque or postal order. Do not send cash. If you wish to pay by credit/ debit card please provide the following details:

Type
Card number
Expiry
Card holder
Issue date
(if applicable)

The following cards are currently accepted: Mastercard, Visa, Switch, Visa Delta.
Please do not send your card.

Future renewal payments

For future renewals you have an option of automatic payment made by Direct Debit Instruction with your bank or building society. Paying by Direct Debit means you will not have to amend your Instruction whenever there is a change in the licence fee. If you wish to pay by this method please tick the appropriate box on the form.

Where to send this application

The completed form should be sent to:

Radio Licensing Centre
P.O. Box 884
Bristol BS99 5LF

Please ensure you enclose:

If you are a full Class B licensee applying for a Class A Amateur Radio (Novice) Licence, please ensure you have given your callsign overleaf as well as enclosing your Novice Morse Test slip.

Please allow 14 days from posting your application for receipt of your licence.

Helpline

If you have any enquiries regarding your application please contact the Radio Licensing Centre (0117) 925 8333.
Our lines are open from 9.00am - 5.00pm Monday - Friday. An answerphone service is available outside office hours.
Minicom number (0117) 921 9550.

In order to comply with the requirements of the Criminal Procedure and Investigations Act (CPI) 1996, all telephone calls to the Radio Licensing Centre are recorded. If you would prefer to write, please write to the above address.

For official use only

Callsign ........................................................
Date issued ........................................................
Type of licence ........................................................
Customer reference number ........................................................
Date validated ........................................................
Date input ........................................................
Officer's signature ........................................................

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The information given on this form is subject to the provisions of the Data Protection Act 1984 and will be used in accordance with the appropriate entry attributed to the Radiocommunications Agency in the register of Date users and Computer Bureaux.

RA 165 (Rev 7)
March 2001
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