Required Fields are marked by an *
36 Characters Maximum

T1 Smith * Family Name (Surname)
T2 John * Given Name
T3 APSA, 2-Star EID Honors & Photo Stars
 (Please use Photo Stars for EID only)
T3 1605 Sunset Ave. * Address 1
T5 Address 2
T6 Clearwater * City
T7 FL * State / Province
T8 33577 * Zip / Postal Code
T9 USA * Country
T10 * E-mail address
T11 PSA Membership Number
T12 Comments/Special Instructions
T13 smith-j-1234-A1.jpg Section A: Image #1 Filename, See instructions below
T14 Bengal Tiger Section A: Image #1 TITLE
T15 smith-j-1234-A2.jpg Section A: Image #2 Filename
T16 Flamingo Section A: Image #2 TITLE
T17 smith-j-1234-A3.jpg Section A: Image #3 Filename
T18 Great Egret Section A: Image #3 TITLE
T19 smith-j-1234-A4.jpg Section A: Image #4 Filename
T20 Pikes Peak Section A: Image #4 TITLE
T21 smith-j-1234-B1.jpg Section B: Image #1 Filename
T22 Blue Moon Section B: Image #1 TITLE
T23 smith-j-1234-B2.jpg Section B: Image #2 Filename
T24 Fish Out of Water Section B: Image #2 TITLE
T25 smith-j-1234-B3.jpg Section B: Image #3 Filename
T26 Seventh Heaven Section B: Image #3 TITLE
T27 smith-j-1234-B4.jpg Section B: Image #4 Filename
T28 Star Wars Section B: Image #4 TITLE

INSTRUCTIONS:   To Start, Click inside Field Window T1.  Use "Tab" Key to advance to next Field. Leave unused fields blank.
Do not use the ENTER Key;  Use "Tab" key or Mouse Click to advance to next field.
Please use the "Submit" button at the bottom of the page after completing the form.

Since there are two possible Sections, please insert the appropriate letter A,B in the Image Filename as shown below:
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)
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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