China Radio Int'l/English

Reception Report Blank

How to write a Reception Report

Home

Your Name___________________________________________________________________________________________

Address______________________________________________________________________________________________

City/Country/Postal Code________________________________________________________________________________

Receiver/Antenna______________________________________________________________________________________

UTC Date/Time______________________________________________________Frequency__________________________

Station Name__________________________________________________________________________________________

Station Address_________________________________________________________________________________________

City/Country/Postal Code_________________________________________________________________________________

SIO Rating: Signal____________________ Interference______________________ Overall_________________

Signal/Overall

5--Excellent

4--Good

3--Fair

2--Poor

1--Nil

Interference

5--None

4--Slight

3--Moderate

2--Severe

1--Extreme

Content______________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

Why I Tuned In________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

Comments/Questions____________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________

Print this form and listen for three consecutive days before sending a report in