The Master of Ceremonies will use this form. Please type or print with dark ink. The Master of Ceremonies must be able to read the information easily.

NAME: _______________________________ CITY: _______________________________

OCCUPATION/SCHOOL: ______________________________________________________

SPECIAL INTERESTS: ________________________________________________________

______________________________________________________________________________

DESCRIBE YOURSELF IN THREE WORDS:

#1 _________________________________ / #2 _________________________________ / #3 _________________________________

WHAT WOULD YOU LIKE TO TELL THE MC: _________________________________

______________________________________________________________________________

SPONSORS: ____________________________ / __________________________

HOBBIES & TALENTS: (CIRCLE THOSE THAT APPLY)

DO YOU COLLECT ANYTHING: _______________________________________________