Application Form

(Application Form--Please highlight and select the application below, then copy it to your word processor to print. 
Hopefully, I'll learn how to make this be a downloadable page soon!  Nancy)

                                           WOMEN’S  STAR CREST AWARD

                                                                              Application for Certification
                         Please print legibly and fill out completely.  If this form is incomplete, it may delay your award.

 
 NAME: _________________________________________________________________________________________

 ADDRESS: _______________________________________________________________________________________

 CITY: ___________________________________________________STATE: ___________ ZIP: ___________________

 PHONE: (         ) __________________________ E-MAIL: __________________________________________________

WE, the undersigned, attest that at (place) ___________________________________________________

on (date)___________________the above named skydiver participated in a ______-Way Star formation,

consisting of at least 8 women skydivers, entering in position # _________, and thereby qualifies for the

WSCR or NWSCR (circle one) Award.  The Star was held for a period of _________seconds on her (or his)

jump #_________.  Note:  Men must have entered 9^th or later on an 8-Woman Star. 

Witnesses on the skydive—Minimum of 8 women signatures required.

(Please include your WSCR # if you already have one.)

1.  _________________________________________________________WSCR # __________

2.  _________________________________________________________ WSCR # __________

4.  _________________________________________________________WSCR # __________

5.  _________________________________________________________ WSCR # _________

6.  _________________________________________________________WSCR # __________

7.  _________________________________________________________WSCR # __________

8. __________________________________________________________WSCR # __________

I have met the requirements to earn the WSCR / NWSCR (circle one) award, and do hereby certify the above
information is true and accurate. 

Signed: _____________________________________________________ Date ___________________

Please mail this form to:  WSCR Awards, 307 Beauregard Heights, Hampton, VA 23669.  Include
a check or money order for $25 made out to WSCR Awards.  You will receive an award card, a
certificate of achievement, and embroidered emblem, and two decals.  

Additional items to order:         WSCR / NWSCR embroidered patches--$8.00 ea.      WSCR decals—3 for $5.00

Note:  The fees cover costs for printing, record maintenance and award items.  “WSCR Awards” is a nonprofit organization
recorded with the IRS and Commonwealth of Virginia.