Fair Queen Application
TIOGA COUNTY FAIR QUEEN CONTEST
APPLICATION FORM
Name___________________________________
Address_________________________________
City____________________________________
State_____ Zip Code______________________
Phone__________________________________
Birthday:
Month _____ Day _____ Year _____ Age_____
Parent's Names____________________________
If Queen becomes pregnant at any time during her reign, she will immediately relinquish her title.
Contestant's Signature____________________________
Parent's Signature _______________________________
PLEASE ENCLOSE RECENT PHOTO AND YOUR
WRITTEN ESSAY OF 300 WORDS OR LESS
Mail application to:
Betsy Derstine
4336 Route 549
Mansfield, PA 16933