Entry Form

Name:
Address:
Telephone: eMail:
Date of Birth:(for youth class Only)
Title of Exhibit:
Brief Description:
lass: No! Of
"rames:
#nsured $alue:
Previous Awards Won:
Name % &ear of the Exhibition: A'ards:
Mode of Delivery and Return of
Exhibit
By (ost
(ersonally
Throu)h Authori*ed (erson
# ha+e read and understood the ,pecial rules of the exhibition and shall abide by
them! # hereby certify that the information furnished by me is correct! # also certify
that i ha+e not participated in any District-.e)ional-ircle-/onal (retain only the
rele+ant le+el) exhibition in the competiti+e class durin) the last t'o years0 except in
111111111111111111111111 (name of District-.e)ion-ircle-/one)
,i)nature of the Exhibitor:
Date:
(lace:
For Offiial !se Only
Entry Number: Date .ecei+ed:
Accepted-Not Accepted Number of "rames
Allotted:
,i)nature of the hairperson of the Allotment ,ubcommittee
Allotment 2etter
Number
Date:
,i)nature of the ,ecretary of the Exhibition: