Candidate Application - Teen - Miss Lane County Scholarship Organization

Are you ready to join one of the countries most exciting and adventurous teen competitions? We hope you will join us!

Candidate Name*
First Last
Age Requirement*
TEEN - Must be at least 13 years of age on the first day of the State Competition in which she competes; and must not be older than seventeen years age as of July 31st in the calendar year of the State Competition in which she competes,unless she is 18 years old and has not graduated from high school as of July 31st in the calendar year of the State Competition in which she competes. 13 to 17-year-old high-school graduates, as well as 18-year-old non-graduates as of July 31st, must compete at the Teen level.
- Teen (13-18)
Date of Birth*
Date Format: MM slash DD slash YYYY
Email*
Candidate Cell Phone
(if applicable)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Year In School*
Age*
Parent/Guardian Name
(if candidate is under the age of 18)
First Last
Parent/Guardian Email
Parent/Guardian Phone
Candidate or Legal Guardian (if under the age of 18) Electronic Signature*
By typing your name, you are confirming that the information provided is accurate, that you have read through the competition information including eligibility and financial requirements, that you meet eligibility requirements, and agree to financial/time commitments required to compete.
Entry Fee*
Each teen contestant is required to pay a $150 entry fee.
Price: $150.00
Total
$0.00
IMPORTANT NOTE: Once you click SUBMIT, you will be taken to PayPal to complete your online payment.