ENTRY FORM       2010 PSA-EID Creative Competition for Individuals
SESSION 2               Closing Date:  November 15, 2010

Please Fill in Required Fields    (Use Lines T13 - T20 for your images)
  
Please read the Entry Rules  before filling out this form.
Please review the Instructions at the bottom of this form.

Required Fields are marked with an *
30 Characters maximum
  T1* Family Name (Surname)
  T2* Given Name
  T3 Honors
  T4* Address 1
  T5 Address 2
  T6* City
  T7* State / Province
  T8* Zip / Postal Code
  T9* Country
T10* E-mail address
T11* PSA Membership Number
T12 COMMENTS / Special Instructions
T13* Section A: Image #1 Filename: A1
T14* Section A: Image #1 TITLE
T15* Section A: Image #2 Filename: A2
T16* Section A: Image #2 TITLE
T17* Section A: Image #3 Filename: A3
T18* Section A: Image #3 TITLE
T19* Section A: Image #4 Filename: A4
T20* Section A: Image #4 TITLE
T21
T22
T23
T24
T25
T26
T27
T28

INSTRUCTIONS:   To Start, Click inside Field Window T1.  Use "Tab" Key to advance to next Field.
You can also use the mouse to click inside the next Field.
Do not use the Enter Key to advance to next Field, The Enter Key will send the Form....
Please use the "Submit" button at the bottom of the page after completing the form.

Use the following Format for your Image Filename:  surname-x-####-yz.jpg
Where x is the first character of your given name.
#### is the last four digits of your phone number.
Where y is the Section Letter (A, B,)   WE WILL USE SECTION-A IN THIS COMPETITION
Where z is the image number (1,2,3,4).

Example:  smith-j-1234-A1.jpg      Image Number 1 entered in Section A, by John Smith, phone no. 727-784-1234

Please PROOF READ your information before you Submit.  To send your entry, Click on the "Submit" Button.


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