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Pork Queen participation form
Please complete form and submit by Oct. 29, 2012.
Pork Queen Participation Form
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Full Name:
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Name you prefer to go by (if different):
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Address:
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City, State, ZIP :
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Phone:
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E-mail Address:
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Birth Date:
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Parents' Names:
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County Represented:
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School:
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Year in School:
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If you are in college, please list college address, e-mail and cell number:
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