Entry Form

Welcome to the
Jennings County Fair Queen Pageant

For information regarding the Pageant,

please contact

Director, Kitty Shepherd

Thank you!

This Entry Form is to be submitted (either online or in paper form) no later than May 17, 2009! NO LATE ENTRIES WILL BE ACCEPTED!!!

Each Contestant is responsible for a $75 entry fee. This entry fee is due on May 17, 2009. The $75 may be collected from several resources. You may collect from your parents, relatives, businesses, etc. Collect the fee from the resources that are easily available to you. If you cannot find the funding for your entry fee, then a committee member will assist you in finding a donor. NO ONE will be excluded for not being able to collect their entry fee!

Your Complete Name:
Your Mailing Address:
Your City, State & Zip:
Your HOME Phone #:
Your CELL Phone #:
Your E-Mail Address:
School (or College) Name:
Grade: (As of August 2009)
Your Age: (As of June 27, 2009)
Your Parent or Guardian's Name: (As you want them listed in the Pageant Program)
Your T-Shirt Size:
Do You Have A Sponsor Yet?:
If You Have A Sponsor, who it is?

I hereby acknowledge that I have read and understand the Terms & Conditions and that the above information is correct:

Yes No

I authorize you to use my typed name as my signature:

Yes No

Signed