LENAWEE COUNTY FAIR
Name_____________________________________________SS# required if placed
Address ___________________________________City,State, Zip _______________________
Phone #_____________________Date of Birth ________________
Father’s name _____________________________________
Address ____________________________________City, State, Zip______________________
Mother’s name ____________________________________
Address _____________________________________City, State, Zip _____________________
Sponsor:_________________________________________
Please include information about your sponsor (20-40 words) ____________________________
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High School __________________________________________Year ____________________
Extracurricular Activities _________________________________________________________
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Awards/Honors Received
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College ______________________________City, State, Zip ____________________________
Major _______________________________ Status____________________________________
Awards/Honors Received ________________________________________________________
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If employed, where?______________________________ Position/Title _____________
Community Activities ___________________________________________________________
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Hobbies/Interest: _______________________________________________________________
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Talent Description (please state if piano is needed) ____________________________________
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Please limit talent act time to not more than 5 minutes
Autobiography: Please attach a 200-300 word autobiography to this entry form.(Please type)
I hereby acknowledge that I have read the official rules and regulations attached to this entry blank. I am complying with them in every way, and that the data herein set forth is correct. I also agree to be available for ALL public appearances if I am either queen or on the court during the week of the Lenawee County Fair. I will be available for a group portrait on July 10, 11a.m. at the Trestle Park. I also will be available for queen practices for group performance (place and time to be determined).
_________________________________Date _________
(Applicant’s Signature)