DUE:  June 15   

Van Buren Youth Fair Entry Form
(Print neatly with an ink pen or type.  Do not use pencil)

Name _______________________   Social Security # ________________

Street ____________________ Town ________________ Zip _________

Parent/Guardian ______________________ Telephone ______________

Open Class ___ 4-H ___ 4-H Club _______________________________

Date of Birth _______________________
                            (Mo./Day/Yr.)

Department (Letter)	Division (Number)	Section (Letter)	Class (Number)	Description of Exhibit

Copies:  1 to Fair Board, 1 to Exhibitor                                               Page ___ of ___

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Last modified: January 9, 2008