Home

TEEN AND TEEN PRINCESS 2003 | About Winnfield, LA | PAST QUEENS | Photo Gallery | More Fun Photos!! | Awards | Sponsors | INTRODUCING OUR PANEL OF JUDGES | ENTRY RULES | PRINTABLE Fact Sheets | TALENT REGISTRATION FORM | ADVERTISING SALES & AWARDS | ADVERTISING SALES CONTRACT | Related Links | Miss Governor City message board
MISS GOVERNOR CITY WINNFIELD, LOUISIANA
PRINTABLE Fact Sheets

MISS GOVERNOR CITY LOUISIANA      #_____
 
FACT SHEET FOR ALL DIVISIONS
 
DIVISION:  MISS___ TEEN___ PRINCESS___  (PLEASE CHECK ONE)
 
FULL NAME_________________________________________________________
( AS YOU WISH IT TO BE LISTED IN THE PROGRAM BOOK)
 
MAILING ADDRESS___________________________________________________
 
CITY, STATE, ZIP_____________________________________________________
 
DATE OF BIRTH__________  AGE____________
 
SOCIAL SECURITY NUMBER_________________
 
HOME PHONE NUMBER____________________
 
EDUCATION:  HIGH SCHOOL:__________________________________________
DATE OF HIGH SCHOOL GRADUATION: (IF APPLICABLE) _________________
COLLEGE:__________________________________________________________
CITY_____________ STATE______________
 
FRESHMAN__ SOPHOMORE___ JUNIOR___ SENIOR___
 (Check one) 
 
CAREER AMBITION__________________________________________________
___________________________________________________________________
 
ACCOMPLISHMENTS_________________________________________________
___________________________________________________________________
___________________________________________________________________
 
EMPLOYMENT EXPERIENCE:___________________________________________
___________________________________________________________________
 
FATHER'S NAME/OCCUPATION:________________________________________
___________________________________________________________________
 
MOTHER'S NAME/OCCUPATION:_______________________________________
___________________________________________________________________
 
NAMES AND AGES OF BROTHERS AND SISTERS:   ________________________
___________________________________________________________________
 
 
 
 

*******************************************************************************
OTHER INTERESTING FACTS ABOUT YOURSELF:
 
 
 
 
PLATFORM ISSUE:
1.  Clearly define the platform issue to which you are sincerely committed and for which you will be an activist during your year of service. ____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
 
2.  What, if any are your most significant accomplishments to date in regard to your platform issue?_______________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
 
3.  Specifically, what do you wish to accomplish during your year of service as an activist for your platform issue?_____________________________________________________________________
_____________________________________________________________________
________________________________________________
_____________________
____________________________________________________________________
 
****************************************************
(Not applicable for Princess Division)
What type of talent will you represent?____________________
(You need not give the exact title of your talent presentation here.  Merely indicate if you will dance, sing, play a musical instrument, comedy reading, drama skit, etc.)
 
Note any special training in music, drama, dance, art, etc:
____________________________________________________________________
____________________________________________________________________
 
********************************************************************
I certify that the foregoing information is true and correct to the best of my knowledge.
 
_______________________           _______________________
Contestant's Signature                     Parent's Signature
_________________
Date
                                                                                                          

Please make sure that information is printed or typed clearly.  Only two complete pages will be accepted.  For better printable registration forms go to (Misslouisiana.com) or call  318/628-2531 or 318/628-5651 and ask for Shonna Moss.