Polly Bond Awards - Payment Form

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For work produced by Full Members of Episcopal Communicators in 2011.

$30 for each General Excellence entry
$20 for the first Regular entry (Writing; Visual Design; Multimedia; etc.)
$15 for 2nd, 3rd, etc. Regular entry (Writing; Visual Design; Multimedia; etc.)

*A Diocese or Parish can pay for multiple people at once, by listing the number of total entries

Name of Member Submitting Entry *

Submit only work for which you had primary responsibility.

Organization, Diocese or Parish *

Mailing Address *

City, State and Zip Code *

Email Address *

Phone Number - Best to use for questions *

Submissions

Number of General Excellence Entries *

Number of Regular Entries *

Payment *

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I am paying by Google Checkout, after I submit all my entry forms.

I am mailing a check, payable to Episcopal Communicators, mail to P.O. Box 6885, San Antonio, TX 78209

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