Fairbury Fair talent show
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STATE DIVISION ENTRY
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Indicates required field
Talent Show Age Division (Choose one)
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Junior Division (10 & Under)
Junior Division (11-14)
Senior Division (15-21)
Age on 8/18/2019
Contestant or Group Name
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Please list name and age of all participants
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Type of Act
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Title of Selection
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Type of accompaniment
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CD, piano, guitar, digital track, etc. Please list if other. If no accompaniment, list "none".
Contact Person
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First
Last
First, Last
Email
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Phone Number
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I understand that this entry is only valid once my entry fee has been submitted and received by mail.
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Option 1
Option 2
Option 3
Please send payment to: Fairbury Fair Talent Show PO Box 1082 Bloomington, IL 61704 (please indicated the name of the contestant)
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