FLORIDA CHALK ARTISTS ASSOCIATION

APPLICATION FOR PROFESSIONAL DESIGNATION

Applicant Name: _______________________

Address:              _______________________

City, State, ZIP    _______________________

Telephone Number     ___________________       email Address: _________________

Member of FCAA since: _________________      Current member (  ) for __________

As a participating member of the Florida Chalk Artists Association, I apply for the professional designation:

(   )   Semplice                    Apprentice

(   )   Qualificato                 Qualified

(   )   Maestro                      Master

(   )   I have attached a log and documentation of my involvement in chalk art/street

        painting events and activities.

(   )    I have provided a separate folder/binder with supporting evidence of my

          chalk art/street painting activities.

References:  (Participating street painters who can verify or attest to my documentation.)

I certify that my application is accurate and that the supporting documentation and attachments represent my street painting involvement and activities.

My application fee of $10 is attached.  Make check payable to:  FCAA

Dated:  ___________________   Signed  _____________________________________