Name (Architect of Record)

2014 AIA Florida/Caribbean

Honor & Design Awards

REGISTRATION FORM

Name (Architect of Record)
Firm
Billing Address
Billing City/State/Zip
Phone
Email
AIA Membership Number
Award Category / # Entries / Entry Fee / Total per Category
Award of Excellence / $125.00*
Unbuilt Design / $125.00*
Theoretical & Research (Assoc. AIA/AIAS Only) / $45.00*
Test of Time / $125.00*
Firm of the Year / $225.00*
Masonry Awards / $125.00*
The Sustainable Design Award / $125.00*
TOTAL

_
* Entries will be charged a late fee of $25.00 if received after March 28, 2014.

Please circle honor award title:

Gold Medal / McMinn Education / Craftsman Award
Silver Medal / Graham Architectural Awareness / Photographer of the Year
Medal of Honor for Design / Clary Government Service / Builder of the Year
Pullara Individual / Associate Individual / Allied Member of the Year
Pullara Chapter / Object Competition

PAYMENT INFORMATION

Check / Visa / MC / Amex
Credit Card Number:
Expiration Date: / CVS Code: / Billing ZIP:
Authorized Signature:

Actual entries are due in the AIA Florida office by April 11, 2014 at 11:59 p.m.

NO EXCEPTIONS PLEASE – LATE ENTRIES WILL BE RETURNED.

Return to Candy Munz via email: ; fax: (850) 224-8048 or mail: AIA Florida, 104 E. Jefferson St., Tallahassee, FL 32301