Reception form

Please complete all fields.

Name:

Gender:
—Please choose an option—FemaleMale
Age:

Profession:

RRI listener since:

Address:

City:

ZIP code:

Country:

E-mail:

RECEPTION EQUIPMENT

Receiver:

Antenna:

Place of reception:

RECEPTION

Date:

Time (start):

Time (end):

Frequency (kHz):

PROGRAM

Language:

Program details:

RECEPTION QUALITY

Signal strength:
—Please choose an option—ExcellentGoodSatisfactoryPoorBarely audible
Interference:
—Please choose an option—NoneWeakMediumStrongVery strong
Noise:
—Please choose an option—NoneWeakMediumStrongVery strong
Propagation disturbance:
—Please choose an option—NoneWeakMediumStrongVery strong
Overall rating:
—Please choose an option—12345

MORE INFORMATION

Comments (remarks, comments, information, suggestions...):

By filling in this form belonging to RRI you consent to the storage of your personal data in the RRI database and to its processing for information, marketing and advertising purposes. RRI complies with the provisions of the General Data Protection Regulation (EU) 2016/679 on personal data protection. RRI will no longer store and use your personal data, upon your specific request, by e-mail.

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