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Application for All-American Certificate/Patch

See the instructions below this order form.

Name

Age Group Sex: M F

Address

City State Zip

Meet Date of Meet

Meet Site Event Mark

Hurdle Height Weight of Implement

Certificate     Patch      Patch Tag

If you have equaled or bettered the standard of excellence, you can use this form to receive a certificate and patch.

A 3-color, 8" by 10" certificate, suitable for framing, and/or a 3-color, 3" by 4" patch will be mailed to you within six weeks. Allow eight weeks for a patch tag.

Instructions

  1. Print this form.
  2. Fill out the form completely.
  3. A copy of your results or a note stating in which issue your results appeared MUST accompany this application.
  4. Please send $10 for a certificate, $10 for a patch, and $10 for a patch tag showing event and year. The cost for both a certificate and patch ordered at the same time is $15.
  5. Mail this order form along with your check made payable to National Masters News and send to

    All-American
    National Masters News
    P.O. Box 1117, Orangevale, CA 95662

National Masters News
P.O. Box 1117, Orangevale, CA 95662
email to nminfo@nationalmastersnews.com - 916-989-6667

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