Application for Star Award, Monochrome Prints

(Please help avoid mistakes by printing neatly or typing.)
 
Mail to Tom Hady, APSA, PPSA, Director, Award of Merit, Monochrome Prints,
6719 Bellamy Ave.,

 Springfield, VA 22152, USA

1.  Name (exactly as it should appear in the certificate, including PSA recognitions) and mailing address:
______________________________________________________________________________

Mailing address__________________________________________________________________
City___________________________State________________Zip_________________________
E-mail address:_________________________________________________________________

2.  Are you applying for a star in ____ Large Monochome Prints or _____Small Monochrome Prints?

3.  What Star are you applying for? _____________

4.  Acceptances (Use Who’s Who totals when listed in Who’s Who)

Total Aceptances as listed in:  Who’s Who _______

Who’s Who Acceptances:
Year No. Acceptances Year No. Acceptances Year No. Acceptances Year No. Acceptances

























Acceptances not listed in Who’s Who.  Include the current year.  Group by salon and year. 
(Use a separate sheet of paper id needed)


      Title                       
Year        Salon             



























 
5. Judging credits (see instructions for number, no new titles):
Year____ Salon___________________ Number ___;  Year____ Salon_________________Number___

6.  How many new titles?________       On a separate sheet of paper, list new titles with one example of a salon (and year) that accepted.  Number consecutively.  Do not list titles from previous stars.

7. Remember to enclose fee ($10 per star award, payable by check to PSA on U. S. bank or cash) and a  photocopy of your PSA membership card.  

Please include your email address above?  Having it can really speed things up if I have questions, especially for foreign competitors.