58th Camellia Queen Pageant 2015

58th Camellia Queen Pageant 2015
Sponsored by: The Biloxi Lions Club
Contestant Application
(Type or Print Clearly)
_________________________________________________________
Last Name: _____________________________First:___________________ Middle: _____________
Address: _______________________________ City: ___________________ Zip Code: ___________
Contestant Birthdate: _____________ Age: ______ Contestant Phone #:____________________
Parent’s Names: _______________________________ Parents Phone #: _____________________
Honors held in community and school:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Hobbies/Interests:___________________________________________________________________
School Presently Attending ______________________________ Grade: _____________________
What are your plans after High School? _______________________________________________
_____________________________________________________________________________________
Sponsor: __________________________________ Contact Person: _________________________
Address: _______________________ City: ___________ Phone #: ___________________________
DATE OF PAGEANT
April 4, 2015
Beau Rivage – Camellia Ballroom
Get Acquainted Party
March 29, 2015
BEFORE RETURNING APPLICATION
Enclose one black & white or Color photo
(head & shoulders) suitable for newspaper
and program. Enclose check/money order
for $75.00 entry fee, payable to
“Biloxi Lions Club”
DEADLINE FOR APPLICATION IS MARCH 12, 2015
Please return to: Mrs. Jaye Brice, 1070 Judge Sekul Avenue, Biloxi, MS 39530
For further information or questions call 228-374-8175
NOTE: If you are interested in selling ads or have your own ad for our program, please visit
the Club website at www.biloxilionsclub.org and click Camellia Queen Program ad form.