Delegate Program

42 DELEGATE -to- ALL STAR APPLICATION TEEN JUNIOR-TEEN PRE-TEEN Parent/Guardian’s Name(s)______________________________________________________ Home Address____________________________________ Membership #________________ City/State/ZIP_____________________________________ Phone:______________________ Email Address _________________________________ Cell Phone: _____________________ SPONSORED BY :_______________________________________________________ (Attach additional sheet if necessary.) 1. In 400 words or less, please attach a self-titled essay describing a personal achievement that you feel was a major accomplishment in your life. 2. Teen Applicant: Attach three letters of recommendation. Junior-Teen Applicant: Attach two letters of recommendation. Pre-Teen Applicant: Attach one letter of recommendation. 3. Junior Teen and Teen Applicant: Attach Personal Development Report detailing equine related enterprises and accomplishments. 4. Teen Applicant: Attach Résumé. Deliver to: MFTHBA, P O Box 1027, 1 Mile North Hwy 5, Ava, MO 65608 Deadline is 4:00 PM May 15 th , 2015 Applicant’s Signature___________________________________________________________ (Date) Parent/Guardian’s Signature_____________________________________________________ (Date) Applicant’s Full Name_____________________________________ DOB_____________________ Home Address__________________________________________ Membership #______________ City/State/ZIP___________________________________________ Phone:___________________ Email Address ______________________________________ Cell Phone: ___________________ Include at least one recent photo of yourself suitable for newspaper reproduction. No limit on number of photos submitted.