First Name: Last Name:

E-Mail Address:

Guardian's name Email:

Address:

City: State: Zip Code:

Phone Number: Cell Phone Number:

Birthdate:

High School: Grade:

College: Major:

What are your plans for the future?

What clubs or activities are you involved in at school?

What community/church activities do you participate in?

What hobbies do you enjoy?

Why do you want to be the Kimberton Fair Queen?

I hereby acknowledge that I have read the Fair Queen Contest Rules, Guidelines & Obligations.
I will comply with them in every way and the personal data as set forth is correct.

Contestant's Signature:

Parent's Signature:

Please submit form to Louise Kritzberger – No later than June 15, 2010. If there are any questions concerning this contest you may contact me at 610-935-8358 or by email at kimbertonfairqueen@gmail.com and I will be more than happy to assist you in any possible way.