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:
Jennifer Thomas Gluszczak
1018 E. Hill Road
Covington, PA 16917