State Winner Entry Form
Please print

Contestant’s Name _______________________________________ 

Address ________________________________________________

City ___________________ State __________ Zip ______________

Phone   (________)_____________________

Parent’s Name ___________________________________________

State Coordinator _________________________________________

Sponsoring State Organization _______________________________

• Please print clearly – the information is used for contestant awards and mailings.

• The contestant will receive a mailing with information regarding the contest time and exact location in the hotel several weeks prior to the contest.

• This form should be sent to the National Contest Director immediately following the state contest.

SEND THIS FORM AND A COPY OF THE WINNER’S SPEECH TO:

Michelle Fischbach
416 Burr Street
Paynesville, MN  56362
Or email the information to michellelfischbach@yahoo.com