Additional Certificate Order FormSTC Washington, DC – Baltimore Chapter2018-2019 Technical Communication Competition

The STC Washington, DC – Baltimore Chapter provides three certificates at no charge for each winning entry. Each additional certificate costs $15.00. To order additional certificates, mail this form and your PayPal receipt (or with a check made payable to STC Washington, DC – Baltimore Chapter) to: Annette Reilly, TreasurerSTC WDCB Competition Recognitions Manager34 N Irving STArlington, VA 22201If you have any questions, contact treasurer@wdcb.stcwdc.org

Type or print the following clearly so we can contact you if we have any questions.

Name:      Street Address:      City:      State:       Zip Code:      Country:      Daytime Phone:      Evening Phone:      E-mail Address:      

Complete the entry title below. In the table, list the names exactly as they should appear on each certificate. Provide a separate form for each entry title. Please print clearly.Entry Title:      

Contributor Name As It Will Appear on Award Cost ($15) U.S.

      $            $            $            $            $      

Total $ Enclosed: $      

Pay using PayPal with the form at pay-by-paypal-for-additional-certificates/