PPD Star Ratings: Application Form
(Please help avoid mistakes by printing neatly or typing.)
Color Prints - Mail to Stuart Bacon, 1320 Benito Avenue, Burlingame, CA 94010-5626, USA
(This form is optional. If you want to include the information in a letter, that’s fine.)
1. Name (exactly as it should appear in the certificate, including PSA recognitions) and mailing address:
Having your email address can speed things up if there are questions.
2. Are you applying for a star in:
Monochrome Prints? ____ Large or _____Small? | Color Prints? ____ Large or _____Small?
3. What Star? ______________
4. How many new Acceptances?________
On a separate sheet of paper, list new acceptances, showing year, exhibition and title. Sort by year and exhibition and number consecutively.
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.
7. Remember to enclose fee ($8.00 per star award, payable by check to PSA on U. S. bank, cash or the optional credit card charge authorization) and a photocopy of your PSA membership card.
Payment by Credit Card (print and fill out this form or download a credit card form in pdf)
Credit Card Type - Visa _____ Master Card______
Credit Card Number _______________________________
Expiration Date _________________
Print Name of Credit Card Holder: ____________________
Signature of Credit Card Holder:_______________________, Date_____________
Authorizing a PSA Total Charge of $__________ In payment of fees for Pictorial Print Division Star Rating.