2023 Scholarship Design Competition Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Shop Name (if applicable)Name *FirstLastLayoutContact Email *Contact Phone *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNumber of Years in the Floral Industry *Please Choose the Option that Describes You Best *FreelancerShop OwnerShop EmployeeI certify that according to the requirements for this competition that I am eligible to compete in the AFA Scholarship Design Competion *AgreeDate / Time *DateTimeIf employee of a member shop, the shop owner must authorize this registration by agreeing below:AgreeShop Owner NameFirstLastCompetition Entry Fee *Price: $ 75.00Stripe Credit Card *CardName on CardSubmit