2014 KLASSY CLUB'S LEADING THE DREAM
Sweet 16 or SWEET SIXTEEN celebration
REGISTRATION ENTRY FORM
March 24th - April 25th
For more information, call (305) 625-9630 ext. 17.

REQUIRED INFORMATION:

Full Name Required
First Name:
Last Name:

Mailing Address Required (No P.O. Box)
Street Address:
Street Address Line 2:
City: State / Province:
Postal / Zip Code: Country:

E-mail Required:

Parent Information Required
Parent Name:
Parent E-mail Required:

: ex. (xxx)xxx-xxxx
: ex. (xxx)xxx-xxxx

Street Address:
Street Address Line 2:
City: State / Province:
Postal / Zip Code: Country:

Birth Date (example: 01/01/19XX
Month: /Day: / Year:

All entries must be electronically signed by a parent or legal guardian to be considered for candidacy process approval.

Electronic Signature X:

Today's Date:

Additional items required to be emailed with this online entry are as follows:

• A minimum of (1) photograph of the entrant MUST be submitted

• A 500 word essay as to why the entrant deserves KLASSY CLUB'S LEADING THE DREAM Sweet 16 or SWEET SIXTEEN celebration OR a video clip of the eligible entrant detailing why they deserve to be a participant in Klassy Club's Leading the Dream – Sweet Sixteen or SWEET SIXTEEN celebration. (Video MUST be a maximum of 2 minutes ONLY and must be submitted via email at info@klassyclub.org.)

• (2) letters of recommendation (1) MUST be from an educator

• A copy of the entrants' birth certificate, or driver's license or current form of ID that provides for proof of birth date.

• A fully executed 2014 Income Certification Form (Click text to download copy)

All information must be submitted accurately (as described above) and completely on the official entrant. Incomplete, falsified or late entries will not be considered for the contest.

I have read and agree to the Terms and Conditions for the KLASSY CLUB'S LEADING THE DREAM Sweet 16 or SWEET SIXTEEN celebration. CLICK HERE FOR CONTEST RULES.

Enter Klassy Club Website Here