1. Optimist Club Farmington – Farmington Hills, MI – 2018 Oratorical Contest Application
  2. Contestant Name(*)
    Please type in contestant's full name
  3. Contestant Address(*)
    Please enter contestant's address
  4. Additional Address
    Please enter additional address information
  5. Contestant City(*)
    Please enter contestant's city
  6. Contestant State(*)
    Please input contestant's state
  7. Contestant Zip Code(*)
    Please enter contestant's Zip Code
  8. Contestant Phone Number
    Please input contestant phone number (123-456-7890)
  9. Contestant Email(*)
    Please enter contestant's Email address
  10. Contestant Birth Date(*)
    / / Please select the contestant's birth date
  11. Contestant Age(*)
    Please select contestant's age
  12. Has contestant participated in any other Optimist Club’s Oratorical Contest this school year?(*)
    Please select Yes or No
  13. Contestant Gender(*)
    Please select contestant's gender
  14. By checking this box, the contestant agrees that they have studied the rules of the contest and will be bound by all of the requirements.(*)
    Please study contest rules and agree to be bound by all of them.
  15. Parent/Guardian Name(*)
    Please enter parent/guardian first name
  16. Relationship to Contestant(*)
    Please select relationship to contestant
  17. By checking this box, I, the parent/guardian grant the Optimist Club/International my permission to use a picture of my son/daughter (the contestant) for their public relations purposes. Optimist Club/International may use the photo in any publication they see fit.(*)
    Please agree to the photo release for Optimists Public Relations use..
  18. Sponsoring Optimist Club Name: Farmington/Farmington Hills
  19. Sponsoring Optimist Club Number: 17150
  20. Application Deadline *** EXTENDED ***
  21. Optionally Mail to: Bruce Fowler P.O. Box 2203 Farmington Hills, MI 48333-2203