2017 Patrick County Agricultural Fair Saturday, September 16, Miss Pageant. Application Fact Sheet APPLICATION MUST BE TYPED (NOT HANDWRITTEN)

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1 Application Fact Sheet APPLICATION MUST BE TYPED (NOT HANDWRITTEN) Ages T-Shirt Size Number. Contestant Full Name: Age as Sept. 16, 2017: of Birth: Parents Name: Mailing Address: County: City: State: Zip: Phone Home: Cell: Facebook: Sponsored by: Height Hair color? Eyes? School and Graduation? College Attending? Class Year as of 1/1/2017 and College Major? Honorary Sorority? Social Sorority? Scholarship Information - Please state how you would use any scholarship monies you may receive from the pageant, the college degrees you are seeking and/or special training you desire?

2 Briefly describe yourself in 25 words or less - High School honors obtained? College honors obtained? Accomplishments obtained with any civic organization, church, or religious groups, etc.? How are you involved with the Patrick County Fair? Hobbies Employment History Interesting facts about yourself or your family Career ambition Please complete this line - In her spare time (your name) Platform Title Give a brief overview of your platform - If you need additional space, please attach an additional sheet. How did you hear about the pageant?

3 Contestant Requirements & Information PRIVATE INTERVIEW which accounts for 50% of the total score will held on Saturday. A staggered schedule will be announced with an approximate time to arrive at the interview area. Required dress for interview competition is business attire. For the first (50) seconds to one (1) minute of the five (5) minute interview, the contestant will present an overview of her chosen platform. If the contestant exceeds the one (1) minute time limit, five (5) points per judge will be deducted from her OVERALL score. No props or note cards will be allowed. Judging will be based on personality, poise, speaking ability, presentation, personal achievement in education, and civic and community participation. PERSONALITY WEAR which accounts for 15% of the total score will be done in a fast-paced modeling style walk. Let your personality shine with an outfit of your choice that best displays your personality, NO sweats. Each contestant will present their public speaking presentation while wearing this outfit. Please be tasteful when choosing this outfit as it will be representative of yourself and your fair. PUBLIC SPEAKING PRESENTATION which accounts for 15% of the total score is a mandatory second speech about the contestant s area or fair. Your name SHOULD NOT be included in this speech as you will be introduced earlier in the program. If the contestant goes over the 30-second time limit, five (5) points per judge will be deducted from her OVERALL score. The purpose of the speech is to allow the judges and the audience to hear the contestant s public speaking ability and observe their stage presentation. Note cards and props are not permitted. Judging of this portion will be on appearance, poise, personality (displayed in your outfit), and the ability to speak fluently. EVENING GOWN COMPETITION which accounts for 20% of the total score will be done in a specific modeling pattern. After the evening gown competition is completed, all scores will be tabulated. An on-stage unrehearsed question will be asked. PHOTOGENIC AWARD. Each contestant is required to bring ONE (8x10) BLACK AND WHITE PHOTO of themselves to be judged for Miss Photogenic. A SIMPLE BLACK FRAME is requested for the picture. These photos will be on display. You are responsible for collecting your photo at the end of the pageant. The Patrick County Fair Pageant Director will NOT be responsible for photos which are left.

4 Rules and Regulations 1. Open to female contestants, who have always been female, single, never married, without children, and never having been pregnant. 2. Contestants must be between the ages of as of September 16, Contestant must possess good moral character having never, at any time, been convicted of any crime nor have any criminal charges against her. Also, the contestant must never have committed an act or engaged in any activity which is or could be characterized as dishonest, immoral, indecent, or in bad taste. This INCLUDES texting, use of the internet and all social media like, Facebook, and ANY other web pages. or photo albums. 4. Interviews will start at 12:00 noon. Location to be determined. 5. The Pageant will be held on, starting at 8:00 PM. Please arrive early and be ready for the pageant to start. If you are unable to attend or will be late, please contact the director. 6. All pageants will be held at the Patrick County High School Auditorium. 7. Pageant entry fee is $60, made payable to Patrick County Agricultural Fair which includes a Miss Photogenic category. Photogenic will be an 8 x 10 headshot photo in a simple black frame. Entry fee includes one adult admission. Additional tickets can be purchased at the door: general admission, Adults $8.00, School age $5.00, and ages 6 years and under are free. 8. Mail application and entry fee to Donna Pendleton Pageant Director -- c/o Stuart Rotary Club -- PO Box 562 Stuart Va questions misspcfair@yahoo.com 9. All applications and payments must be received by September 7, 2017 (you can bring to scheduled practice). 10. Practice date/time to be announced later. 11. Contestant will compete in private interview, personality wear, public speaking and evening gown. 12. Contestant and all accompanying members or guests will conduct themselves in a proper manner at ALL times. Any display of uncooperative or unsportsmanlike conduct will result in disqualification of the contestant. 13. The winner will be qualified to compete in the Miss Virginia Association of Fairs Scholarship Pageant held in January First runner-up must be willing to assume all duties in the event the winner is unable and/or unwilling to fulfill her reign. 15. All judge s decisions are final. 16. Any feedback must be submitted in writing to the pageant director within a timely manner after the pageant. NO scores will be given out the night of the pageant. The Patrick County Agricultural Fair/Stuart Rotary Club and all its agents cannot be held responsible for accidents, injury, or loss of any personal property relating to this event. I have read the entry form and agree to abide by the pageant rules. Failure to do so may result in disqualification. Contestant s Signature (if under 18 a parent must also sign) Parent s Signature/ Make checks payable to the Patrick County Agricultural Fair in the amount of $60. Mail application and check to the Donna Pendleton, Pageant Director (address below) by September 7, 2017 Check No. Amount

5 Media Release MEDIA RELEASE FORM: I hereby give my consent for the use of image, voice or likeness from video- tapes, photographs, motion picture film, electronic images and/or other technologies in which I appear/minor child and/or audio recording made of my voice may be used by Stuart Rotary Club. Furthermore, I hereby consent that such photographs films, recording, electronic images and the film, slides, disks plates or tapes from which they are made shall be their property, and for appropriate organizational uses, including internet use. I have read the entry form, media release form and agree to abide by the pageant rules. My child may participate in the Patrick County Fair Pageant. Parent/Guardian s Signature Contestant s Signature (if under 18 a parent must also sign)