2015 Senior Ms. Lumbee Pageant Application

Transcription

2015 Senior Ms. Lumbee Pageant Application
Senior Ms. Lumbee
Mrs. Joyce McMillian
Senior Ms. Lumbee 2014
Pageant Application 2015
Mail completed applications by May 29, 2015
Lumbee Tribe Elder Services
Attention:
Bobbi Jo Oxendine
P.O. Box 2709
Pembroke, NC 28372
Revised 4/14/15
• Applicant Criteria and rules is as follows: o Must be 55 or older. o Must be an enrolled member of the Lumbee Tribe and be able to provide proof. o Must be officially sponsored by a Lumbee Tribe Heritage Group, business, organization or individual, etc. o If a contestant would like to see their scores after the pageant they will need to make an appointment with the Elder Services Department. No one will be allowed to pick up your score sheets from the office or view the scores on your behalf. This is a confidentiality issue that we must to adhere by. o The contestant must sign application. o Talent presentations are limited to (5) minutes. o Must return completed applications with registration fee of $100.00 ** by May 29, 2015. Applications may be dropped off at the Elder Services offices or should be mailed to:  Lumbee Tribe of NC Attention: Bobbi Jo Oxendine Elder Services Department P.O. Box 2709 Pembroke, NC 28372
For more information please contact Bobbi Jo at 522-2196.
Revised by BJO 4/14/15
Senior M s . Lumbee Pageant
Cont estant Application 20 15
First Name
Last Name
Middle Name
Address (street number and name)
City
State
Zip Code
North Carolina
Date of Birth
Home Phone (include area code)
Age
____________________________
MM/DD/YYY
___________
TELL US ABOUT YOUR FAMILY
Marital Status:
Single
Married
Separated
Divorced
Widowed
Name of spouse _________________________________________________________________________
Number of children you have? _________
Number of grandchildren you have? ________
Number of great-grandchildren you have? __________
TALENT INFORMATION
Is your talent
Contemporary (Singing, etc.) or
Traditional (Storytelling, sign language, etc.)
Description of Talent ______________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If singing, please list song
title_______________________________________________________________
Revised by BJO 4/14/15
What equipment will you need? _____________________________________________________________
AWARDS/HONORS (please list any awards or honors you have received)
Revised by BJO 4/14/15
HOBBIES (please list/describe your hobbies)
Revised by BJO 4/14/15
COMMUNITY INVOLVEMENT (please describe your involvement with your local community).
You may include any work, volunteer, church or tribal activities you have participated in.
As Senior Ms. Lumbee what message would you convey about American Indians in North
Carolina and to the general public?
Revised by BJO 4/14/15
SPONSOR INFORMATION (please list name and address of sponsor or sponsoring organization)
Please include Registration Fee of $100.00 with application. Make checks/money orders payable to the
Lumbee Tribe of NC.
Name of Sponsor: ___________________________________
Contact Person: ______________________________________________
Address:____________________________________________________
City: ____________________________________
FOR OFFICE USE ONLY
Registration Fee: $100.00
Date received____/____/____
Check # _______
Money Order
Cash
State: _____________ Zip Code: _____________
Tribal Enrollment #____________
Phone: (
Contestant #______________
)__________________ Fax: (
) ___________________
(Attach photocopy)
ACKNOWLEDGEMENT STATEMENT
I agree not to hold the Lumbee Tribe of NC or any organization, facility or board member associated with
this event liable for any loss, injury, theft or otherwise occurring before, during or after participation in this
event. I agree to abide by LTNC rules and decision. I agree that I will not pursue legal action against
LTNC or its members in any form. I agree to allow my photo to be used in future LTNC advertising.
Should I win the title, I agree to be available for public appearances and I agree to attend the pageant next
year to relinquish my title to my successor.
_________________________________________________________________
Contestant Signature (unsigned applications will not be processed)
________________
Date
_________________________________________________________________
Sponsor Signature
________________
Date
_________________________________________________________________
Bobbi Jo Oxendine, Elder Services Manager
________________
Date
*Incomplete applications will not be accepted. *
Revised by BJO 4/14/15