* 1. This Survey Closes June 1... APS Chapter/Affiliate Name:

* 2. APS Chapter/Affiliate Number:

* 3. Web Site Home Page URL:

* 4. Web Site Class (check one):

* 5. Entrant’s Name:

* 6. Entrant's Email:

* 7. Relation of Entrant to the Organization:

* 8. Comments or questions. Thanks! You will now be taken to the Survey Monkey exit page, which also acts as your confirmation that your entry has been received. Contact Tom at stamptmf@frontiernet.net with any specific questions about the APS web awards program. If you are submitting more than one entry, clear your web browser's cache and cookies before attempting the next entry. Survey Monkey is logging that and your IP address. If you still have a problem, please email Tom.

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