Miss Permian Basin Fair:

Information Sheet
Registration Form
Resume
Pageant Dress Information
Schedule of Events
Pageant Rules

Download the full
Scholarship
Pageant Packet
HERE

MISS PERMIAN BASIN FAIR & EXPO
SCHOLARSHIP PAGEANT  

REGISTRATION FORM

 COPY, PRINT, AND RETURN THIS PAGE:

 NAME________________________________SOCIAL SECURITY #_____________________

 ADDRESS___________________________________CITY______________ZIP____________

 AGE________BIRTH DATE____/____/____EYE COLOR________HAIR COLOR___________

 TELEPHONE (HOME)___________________________(WORK)________________________

 SCHOOL____________________________________GRADUATION DATE________________

 OCCUPATION______________________COMPANY__________________________________

 COLLEGE OR UNIVERSITY (ATTENDING OR PLANNING TO ATTEND)

 _____________________________________________________________________________

 PARENT(S) NAME(S)___________________________________________________________

 PHONE (WORK)________________________________(HOME)________________________  

               Registration fee...................................................................$50.00

               T-shirt fee..............................................................................10.00

                                                                                               Total     $60.00

 
           My/Our contribution to the Fair Scholarship fund is ………..$____________

                                                                                                  Total  __________

     _______Check or cash enclosed     

      _______Yes, I would like a tax deductible statement for my contribution to the
                  Scholarship Fund.

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