COMPETITIONS

In This Section
The Competitions..Page 2
Interview Competition.. Page 2
Personal Introduction Competition. Page 3
Fun Fashion Competition ...... Page 3
Evening Gown/Formal Wear Competition... Page 3
Pageant Competition Judging.Page 3
Talent CompetitionPage 5
Casual Wear.. Page 5
Spokesmodel. Page 5
Photogenic Competition. Page 6
Supermodel with Style. Page 6
Photo Shoot Competition.Page 6
Commercial Auditions.. Page 6
International Spirit Award Page 7
Academic Achievement Award ... Page 7
Volunteer Service Award. Page 7
Appearance Award... Page 7
State Scrapbook Award Page 7
Press Release Award . Page 7

This Sections forms

Personal Interview Form (ages 4 18 yrs).. Page 8
Personal Interview Form (ages 19 24 yrs).. Page 9
International Spirit Award Entry FormPage 10
Optional Entry Form. Page 10
Talent Information & Introduction Form Page 11
Academic Achievement Form .. Page 12
Volunteer Service Entry Form Page 13
Appearance Award Entry Form.. Page 14

International Pageant
THE COMPETITIONS:
INTERNATIONAL PAGEANT COMPETITION:
The International Pageant consists of three competitions for the Jr. Princess, Princess & Pre-Teen Divisions:
Interview, Personal Introduction & Formal Wear/Evening Gown Competition.
The International Pageant consists of four competitions for the Jr. Teen, Teen & Miss Divisions:
Interview, Personal Introduction, Fun Fashion & Formal Wear/Evening Gown Competition.
Interview: The Interview Competition is a great time to let the
judges know just why they should pick you as the next International
Junior Miss International Queen. Our judges are warm and friendly.
The judges would like to see a kid being a kid, and a teen who
enjoys being a teenager.
Miss delegates will have the opportunity to speak a little bit
more about their plans for the future. There are no political,
religious or text book questions. The judges just want to get to know
who you are! Delegates should wear a nice dress or two piece suit
for this competition. The interview schedule will be provided at
registration. You will need to be downstairs and in line for your interview
at least 15 minutes prior to your groups scheduled interview. If you are
late for your interview, there is a minimum deduction of 2 points per judge.
You will enter the interview competition in a group of three.
Each delegate will give an introduction of no more than 25 seconds (see personal introduction section).
SAMPLE INTERVIEW QUESTIONS . . . . .
Judges will take most of your interview questions from your Interview Questionnaire. We have listed below
additional questions you may be asked during interview competition:
Ages 4 - 9 years
If you could have one wish, what would you wish for?
What things do you like to do with your family?
What is your favorite subject in school?
Ages 10 - 12 years
What do you like most about school?
What has been the best part of your weekend so far?
If you could meet any famous person in the world, who would it be and why?
Ages 13 & older
Why do you want to be the next IJM International Queen?
Who is your favorite person and why?
If you could chose to have dinner with one person, who would it be and why?
What is one thing that you would like to change about yourself and why?

International Pageant
Personal Introduction: Your personal introduction will be presented during the
interview competition and should be very fun and up-beat. The introduction should
be no longer than 25 seconds and should include your name, age, and something
exciting about yourself. It can be about your hobbies, why you entered the pageant
or your plans for the future. It is your time to shine, so be creative.
Fun Fashion: (For ages 13 years and up ONLY): This year, the 2008
royalty was invited to attend a Red-Carpet event in Los Angels,
California in honor of Kaitlyn Bruce, the International Miss, for her
Supermodel Magazine Cover. Each delegate will model an outfit
of her own choosing. It must be age appropriate, and it should
portray the delegates personal sense of style and fashion. It can
be as simple or ornate as you would like. No denim jeans or high
glitz attire will be permitted. Choose an outfit that you
would wear to a Hollywood Premier.

Formal Wear/Evening Gown: All delegates must

wear a floor length gown that is age appropriate for
the formal wear/evening gown competition. Remember,
fit & style is very important in the formal wear competition.
Delegates are judged on grace, poise and elegance of
carriage during their presentation.

Pageant Competition Judging

The panel of judges will give a score ranging from 1 15 points in each category. The judges will break all
ties. All judges decisions are final.
PROGRAM STANDARDS: Delegates ages 4 9 years are not allowed to wear make-up. Only lip gloss will
be permitted. Delegates ages 10 12 may wear light powder, foundation, mascara & lip gloss for
interview and light make-up for the stage competition. Hair pieces, false lashes, flippers, etc should not
be worn unless they are medically necessary on delegates ages 12 and under. Delegates ages 13 and
older should consider natural make-up for interview competition and appropriate make-up for all other
competitions.
WINNERS & TOP FIVE FINALIST: One winner in each division will receive a Cash Scholarship of up to $5000
and spectacular gift package. The remaining top five finalists will receive an awesome gift package.
ADDITIONAL FINALIST AWARDS: Finalist will be recognized as follows: Top Ten: 21 35 delegates in a
division; Top Fifteen: 36 or more delegates in a division. Finalists will receive a special finalist trophy.

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Optional
Competitions

11

Talent Competition
TALENT COMEPTITION: $75 Per Entry
You may enter up to two talent performances during the optional
competition. Each talent performance is scored individually and counts as its
own entry.
Talent Music Guidelines: Talent performance may not be longer than 2
minutes. If music is to be used, it must be turned in on a CD and must have a
definite end to the song that you are using. Your talent CD is due in the
pageant office along with your talent introduction form by June 1, 2009. You
must bring one back-up copy with you to the competition to keep in the
dressing room or audience. Individual talent rehearsals will not be held during
the competition weekend. All talent performances that require speaking or
singing (does not include cheer competition) must use a microphone.
All props must be small enough to be carried onto the stage by no more than one person. All props should be a functional part of
your talent performance. Any equipment other than a piano, microphones and sound equipments must be supplied by the
participant. Lavaliere microphones will be available but are not recommended for vocal performances.
The panel of judges will give a score from 1 15 points in each category based on entertainment value, skill and overall
presentation. The judges will break all ties. All judges decisions are final. The Talent Winner in each age division will receive a cash
prize of $250 and trophy. The first and second runner-up in each talent division will receive the beautiful keepsakes IJM signature
trophy.

Casual Wear Competition

CASUAL WEAR MODELING COMPETITION: $75 Per Entry

Causal Wear can be any type of casual clothing. Denim is allowed in the casual wear competition.
Ideal outfits for spring casual wear clothing are capri pant, sundresses, skirts and tops, pant and blouse
combinations. Pro-am routines are not allowed. Modeling instructions will be given at the rehearsals
and must be followed.
The panel of judges will give a score from 1 15 points in each category based on modeling technique
and overall presentation. The judges will break all ties. All judges decisions are final. The Casual Wear
Winner in each age division will receive a cash prize of $250 and trophy. The first and second runner-up
in each talent division will receive the IJM beautiful keepsakes signature trophy.

Spokesmodel Competition

SPOKESMODEL COMPETITION: $50 Per Entry

The Spokesmodel competition is limited to one entry. International titleholders will soon become spokesmodels for the
International Junior Miss Scholarship Program. Delegates must deliver a 30-second commercial on their state/region
telling the audience why they should visit their home state, region, city or town. Sign language, singing, acting or rhyming
(other than if it is a part of your state/city/towns slogan) is not allowed. This is not a part of the commercial competition
and may not be used for the commercial competition. Attire: Interview Suit or Dress.
The panel of judges will give a score from 1 15 points in each category based on content and overall presentation. The
judges will break all ties. All judges decisions are final. The Spokesmodel Winner in each age division will receive a cash
prize of $150 and trophy. The first and second runner-up in each spokesmodel division will receive the IJM beautiful
keepsakes signature trophy.

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Photogenic Competition
Photogenic Competition: $75 Per Entry (limit three entries)
The photogenic competition is optional. Photogenic pictures should be at least 5 x 7 inches and no larger than 8 x10 inches
in black & white or color. Photos are due at registration and must fit inside the 8 x 10 sheet protector that is enclosed in your
handbook. Do not mail your photo. You may enter the photogenic competition up to three times. Additional sheet
protectors will be provided at registration if needed. The winner of the photogenic competition in each division will receive
a $250 cash prize and keepsakes trophy. Two finalists will be named and will be awarded a keepsakes trophy.

Supermodel with Style Competition

IJM Supermodel with Style: $75 Per Entry (limit one entry)
The IJM Supermodel with Style competition is an optional competition. There will be one winner selected between the ages
of 4 and 12 years and one winner selected ages 13 years and older. Winners will receive a FULL PAGE COLOR Showcase in
an upcoming Issue of Supermodels Unlimited Magazine, Trophy, Crown and Banner. You can enter in advance or enter at
registration. You must enter the casual wear competition to qualify for the Supermodel with Style Award. Winners will be
selected from a combination of stage performances and pictures submitted for the program book including photogenic
pictures, delegate roster and ads in the program book.

Photo Shoot Competition

Photo Shoot Competition: $50 Per Entry (limit two entries)
The Photo Shoot Competition is an optional competition. There will be one winner selected between the ages of 4 and 12
years and one winner selected ages 13 years & older. The Photo Shoot Competition is limited to 30 delegates ages 4 12
years and 30 delegates ages 13 years & older. The Photo Shoot winners will receive a keepsakes trophy and will be featured
in the Once Upon A Dream Catalog, Website and Printed Material. Winners will also receive a Once Upon A Dream Gift
Basket with Dream Products and opportunities for call backs with talent/model agencies. And finally, one person will
receive a contract with Patrick Modeling & Talent Agency. The attire for the Photo Shoot Competition is the Simply
Wonderful Dream Tank. See General Info Section for more information. Winners must be available on Sunday, July 12th
between 8am and 12 noon for their catalog photo shoot.

Commercial Auditions

Commercial Auditions: $50 Per Entry (limit two entries)

The commercial audition is an excellent tool for agents to see who is ready to be in front of the camera. At the 2007 ANMTC
International Finals, all but one delegate that received call backs participated in the commercial competition. You will be
allowed to choose a commercial script from the scripts that are provide or create your own 15 second commercial
advertising the International Junior Miss Scholarship Program. The attire for the Commercial Competition is the Simply
Wonderful Dream Tank. See General Info Section for more information. The winner of the commercial competition in each
division will receive a keepsakes trophy and an opportunity for a call back with talent agencies.

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International Spirit Award

IJM INTERNATIONAL SPIRIT AWARD: The IJM International Spirit Award Trophy is a great keepsake to take home to show your
spirit of competition from the weekend of the International Finals. Its easy to do, and ITS FREE. To earn a spirit award
trophy, all you need to do is add up the total amount of points below and turn in your spirit award entry form. A participant
with 8 or more points automatically qualifies for the IJM International Spirit Award. The Spirit Award Entry Deadline is June
15th. Spirit Award Points: Pageant Competition (2.5 pts); Talent Competition (1 pts); Casual Wear Competition (1 pts);
Photogenic (1 pt); Supermodel with Style (1 pt); Spokesmodel Competition (.5 pts); Commercial (.5 pts.); Photo Shoot (.5pts),
Program Book Ad Sales over the amount of the required page (2 pts per full page, 1.5 pts per half page, 1 pt per quarter
page and spotlight ad 0.5 pts). The International Spirit Award will be presented at the 2009 Welcome Banquet/Orientation.

Academic Achievement

The Academic Achievement Entry is FREE. Complete the academic achievement form and return it with a copy of your
report card/transcript to be considered for the academic achievement award. The Academic Achievement Award will be
presented at the 2009 Welcome Banquet/Orientation. The entry deadline is June 15th. If you will not receive your final
grades until after June 15th, you must send in the entry form by the June 15th deadline and send in your report
card/transcript by July 1st.

Volunteer Service

The Volunteer Service Entry is FREE. This competition is open to the Jr. Teen, Teen & Miss division only. Complete the volunteer
service form and return it to be considered for the volunteer service award. The Volunteer Service Award will be presented
at the 2009 Welcome Banquet/Orientation. The entry deadline is June 15th.

Appearance Award

The Appearance Award Entry is FREE: Make appearances in your sash and record them on the Appearance Award Entry
Form. You must attach photos of at least 50% of your appearances to be considered. The delegate with the most official
appearances in her state sash will receive an award. The Appearance Award for each division will be presented at the 2009
Welcome Banquet/Orientation. The entry deadline is June 15th.

State Scrapbook Award

The State Scrapbook Award Entry is FREE. Take photos and make appearance with your state sash, make a scrapbook and
enter your scrapbook in the State Scrapbook Contest. Scrapbooks are due at registration and will be displayed throughout
the weekend. The Sate Scrapbook Award will be presented at the 2009 Welcome Banquet/Orientation.

Press Release Award

The Press Release Award Entry is FREE. Complete the enclosed press release and send it to your local newspaper for
publication. If your article is printed, send a copy to international office and you will receive a press release recognition
award at the 2009 Welcome Banquet/Orientation. Do not send your press release form to the international office. To be
considered for this recognition award, be sure to send off your press release early. Press release articles must be received by
June 15th.

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PERSONAL INTERVIEW FORM (ages 4 18)

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)
City_____________________________________________

State___________________________________

Favorite Movie __________________________________

Clubs & Organizations: (list up to five)

Favorite Superhero_______________________________

a. ____________________________________

Favorite Cartoon Character ______________________

b. ____________________________________

The three things that my friends like best about me:

c. ____________________________________

1. _______________________________________________

d. ____________________________________

2. _______________________________________________

e. ____________________________________

3. _______________________________________________

Special Honors, Awards & Recognitions:

Of all of my material possessions, the one that I

a. _____________________________________

treasure most is __________________________________

b. _____________________________________

In five years, I plan to ____________________________

c. _____________________________________

__________________________________________________

d. _____________________________________

__________________________________________________

e. _____________________________________

When Im by myself, I like to _______________________

Special Talents:

__________________________________________________

________________________________________

My dream job in life is to become _________________

________________________________________

__________________________________________________

________________________________________

Please do not duplicate or add anything to this form.

Please print neatly with a blue or black ink pen. Your handwriting will not be judged.
You will need 4 copies of this form on plain white paper. This form is due at registration.

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PERSONAL INTERVIEW FORM (ages 19 & older)

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)
City_____________________________________________

State___________________________________

Favorite Movie __________________________________

Clubs & Organizations: (list up to five)

Favorite Magazine ______________________________

a. ____________________________________

Favorite T. V. Personality__________________________

b. ____________________________________

The three things that my friends like best about me:

c. ____________________________________

1. _______________________________________________

d. ____________________________________

2. _______________________________________________

e. ____________________________________

3. _______________________________________________

Special Honors, Awards & Recognitions:

Of all of my material possessions, the one that I

a. _____________________________________

treasure most is __________________________________

b. _____________________________________

In five years, I plan to ____________________________

c. _____________________________________

__________________________________________________

d. _____________________________________

__________________________________________________

e. _____________________________________

When Im by myself, I like to _______________________

Special Talents:

__________________________________________________

________________________________________

My dream job in life is to become _________________

________________________________________

__________________________________________________

________________________________________

Please do not duplicate or add anything to this form.

Please print neatly with a blue or black ink pen. Your handwriting will not be judged.
You will need 4 copies of this form on plain white paper. This form is due at registration.

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INTERNATIONAL SPIRIT AWARD ENTRY FORM

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)

ENTRY FORM DUE: June 15, 2009

Pageant Competition
____ x 2.5
Talent Competition
____ x 1.0
Causal Wear Competition ____ x 1.0
Photogenic Competition ____ x 1.0
Supermodel with Style
____ x 1.0
Spokesmodel Competition ____ x 0.5
Commercial Competition ____ x 0.5
Photo Shoot Competition ____ x 0.5

= _____
= _____
= _____
= _____
= _____
= _____
= _____
= _____

Ad Sales (full page)

Ad Sales (half page)
Ad Sales (quarter page)
Ad Sales (spotlight ad)

____ x 2.0
____ x 1.5
____ x 1.0
____ x 0.5

= _____
= _____
= _____
= _____

TOTAL POINTS: _________

CUT ALONG LINE

OPTIONAL ENTRY FORMS

Name ____________________________________________________________________________________
Division:

___ Jr. Princess (4 -6 yrs)

___ Jr. Teen (13 15 yrs)

___ Princess (7 9 yrs)

___ Teen (16 18 yrs)

___ Pre-Teen (10 12 yrs)

___ Miss (19 24 yrs)

Talent Competition Entry: (up to 2 entries)

# of Entries @ ____ $75 Entry Fee =

$___________

Casual Wear Competition Entry:

# of Entries @ ____ $75 Entry Fee =

$___________

Photogenic Competition Entry:

# of Entries @ ____ $75 Entry Fee =

$ __________

Supermodel with Style Competition Entry:

# of Entries @ ____ $75 Entry Fee =

$ __________

Spokesmodel Competition Entry: (limit 1 entry)

# of Entries @ ____ $50 Entry Fee =

$ __________

Commercial Competition Entry: (up to 2 entries)

# of Entries @ ____ $50 Entry Fee =

$ __________

Photo Shoot Competition Entry: (up to 2 entries)

# of Entries @ ____ $50 Entry Fee =

$ __________

TOTAL

$ __________

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TALENT INFORMATION & INTRODUCTION FORM

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)
Type of Talent: __ Dance

__ Vocal __ Monologue ___ Other ______________________________________

Exact time of performance: ___________

Music: ____ Yes

Type of Microphone: (circle one)

microphone stand

hand-held

___ No
lavaliere

Special equipment/props: __________________________________________________________________________

Comments/Special Instructions: _____________________________________________________________________
The parent or delegate (age 18 years and older) must read the INTERNATIONAL JUNIOR MISS TALENT COMPETITION
Guidelines, initial each line, sign and date this form below. Failure to abide by the INTERNATIONAL JUNIOR MISS Talent
guidelines may result in point deductions or disqualification (as determined by the Executive Producer and/or judges)
without refund of any fees paid.
_____ 1.

I understand that my talent must not exceed 2 minutes.

_____ 2.

I understand the following regarding my Talent CD:

a. Talent CDs are due in the pageant office by the deadline (June 1, 2009). Late CDs will not be accepted.
If you do not turn in your talent CD, you will not be allowed to participate in the Talent Competition. This
rule will be strictly enforced. You must turn in one back-up copy of your talent CD at registration and keep
a back-up copy in the audience of in the dressing room in case of an emergency.
b. Talent CDs must be labeled with your name written on both, your CD and Cover.
c. Your Talent Music must be the only track on your Talent CD.
d. Your Talent Music must have a definite end. If there is a fade, it must be recorded and completed within
the time limit.
e. If you need assistance with Talent CDs, please call or email us. www.musicalcreations.com is a great site
for performance music.
I understand that my talent presentation may not include any object or substance that is deemed dangerous
by the pageant including fire, knives, glass, etc. If you are in doubt, please contact the pageant office.
I understand that any props used during the presentation must be a functional part of the presentation.
I understand that there will be no talent rehearsals prior to the talent competition. The stage will be available for
simple walk-through.

_____ 3.
_____ 4.
_____ 6.

I have read and understand talent guidelines for the INTERNATIONAL JUNIOR MISS Talent Competition.
___________________________________________________________________
Parents Signature (delegate age 18 yrs or older)

________________
Date

TALENT INTRODUCTION: Example :

Combine the classic sound of David Bowe with the vocal talents of Tina Turner and you generate an unstoppable energy!
Lets welcome Jamie Wells to the stage with her jazz dance rendition to . . . .

____________________________________________________________________________

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
_________________________________________________________________________________________________________________

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ACADEMIC ACHIEVEMENT ENTRY FORM

Name ____________________________________________________________________________________
Division:

___ Jr. Princess (4 -6 yrs)

___ Jr. Teen (13 15 yrs)

___ Princess (7 9 yrs)

___ Teen (16 18 yrs)

___ Pre-Teen (10 12 yrs)

___ Miss (19 24 yrs)

ENTRY FORM DUE: JUNE 15, 2009

A copy of the students transcript or last report card for the 2008 2009 school year must be attached.
If you will not receive your final grades until after June 15th, you must send in the entry form by the June
15th deadline and send in your report card/transcript by July 1st. Check the box below if you will be
sending in your report / transcript after the June 15th deadline.
Name of Teacher ____________________________________________________

Grade/Classification____________________

School _________________________________________________________________________________________________________

I, _______________________________________________________, recommend the above listed state delegate

for the International Junior Miss Scholarship Program Academic Achievement Award for her division.
Please describe briefly why you believe that this student should receive the 2009 International Junior Miss
Scholarship Program Academic Achievement Award for her division.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
______________________________________________________________________________________________________
_________________________________________________________________
Teachers Signature

____________________
Date

I will not receive my final report card/transcript until after June 15, 2009. I understand that I must return this form by
the June 15th deadline and my final report card/transcript by July 1, 2009 to be considered for the Academic
Achievement Award.

_________________________________________________________________
Delegates Signature

____________________
Date

19

VOLUNTEER SERVICE ENTRY FORM

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)

ENTRY FORM DUE: JUNE 15, 2009

Example

Name of Event American Red Cross Food Drive

Place the name of the event here.

Type of Event Food Drive for Red Cross Relief

Describe the type of event here.

Date August 25, 2008

List the date of the event. Event dates must fall between 6/01/08 & 6/01/09

Contact Person Mary Smith

The person in charge of the event should be placed here.

Telephone Number 912-555-1234

The telephone number of the person in charge should be placed here.

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

20

APPEARANCE AWARD ENTRY FORM

Name ____________________________________________________________________________________
Division:
___ Jr. Princess (4 -6 yrs)
___ Princess (7 9 yrs)
___ Pre-Teen (10 12 yrs)
___ Jr. Teen (13 15 yrs)
___ Teen (16 18 yrs)
___ Miss (19 24 yrs)

ENTRY FORM DUE: JUNE 15, 2009

Example

Name of Event American Red Cross Food Drive

Place the name of the event here.

Type of Event Food Drive for Red Cross Relief

Describe the type of event here.

Date August 25, 2008

List the date of the event. Event dates must fall between 6/01/08 & 6/01/09

Contact Person Mary Smith

The person in charge of the event should be placed here.

Telephone Number 912-555-1234

The telephone number of the person in charge should be placed here.

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

Name of Event _________________________________

Name of Event _______________________________

Type of Event

Type of Event _________________________________

__________________________________

Date ___________________________________________

Date _________________________________________

Hours Served ___________________________________

Hours Served _________________________________

Contact Person ________________________________

Contact Person _______________________________

Telephone Number _____________________________

Telephone Number ____________________________

* You must attach a photo of at least 50% of your appearances to be considered for the award.

21