MONONA COUNTY FAIR QUEEN CONTEST ENTRY FORM 2012 Please complete this form and return to Sharyl Bruning, 39467 State Hwy 175, Mapleton IA 51034

postmarked by June 23, 2012. NO EXCEPTIONS! Please include a current wallet size photo

(head and shoulders shot) – or a photo may be emailed to bruning@wildblue.net. Please include a

$30 entry/sponsor fee and make checks payable to Monona County Fair Association. PLEASE

MAKE SURE INFORMATION IS ACCURATE SINCE WE USE IT IN THE LOCAL

NEWSPAPERS and AS A SHORT INTRODUCTORY BIO TO BE READ THE AT THE

EVENING CONTEST! It is your responsibility to read all rules of the competition.

Please complete this form and add additional pages as necessary. It is highly suggested that you

copy & paste this application into a document you can type into. Explain any acronyms.

Name: Age & date of birth:

Contestant’s email: Do you check email regularly? Yes or No

Address: Contestant’s cell phone:

Parent/Guardian name: Home Phone:

Parent’s email: Do you check email regularly? Yes or No

Sponsor(s):

Sponsor’s town:

Name of High School: Graduation date:

Activities and Interests 1. Please list extracurricular activities, honors, and awards:

2. Please list and describe your community, school, church, or civic involvements:

3. Describe your interests and hobbies:

4. Describe your future plans and career goals:

5. Tell us one of your most memorable experiences:

On a separate sheet, in 250 words or less, describe why you should be selected as the 2012

Monona County Fair Queen.

Falsification of any information will result in disqualification.

I have read the qualification requirements and expectations of the Monona County Fair

Queen Contest and wish to be considered an applicant.

Signature: _____________________________ Date: ____________________