(Please help avoid mistakes by printing neatly or typing.)
Monochrome Prints - Mail to Tom Hady, APSA, PPSA, 6719 Bellamy Ave., Springfield, VA 22152, USA
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.Send and a photocopy of your PSA membership card. The fee is 8.00 per star award. If you are paying by cash or a check to PSA on a U. S. bank , send it with your application. If you want to use PayPal, wait until your application has been approved, and we will send the information on how to pay.