ENTRY FORM

NAME: __________________________________________________

ADDRESS: _________________________________________________________________________

                                (Street)              (City)            (State)  (Zip code)

PHONE NUMBER: (____)___________ I.C.S. No.________________________________________

I will be participating in (please mark)

State Cook-off (Saturday)            

Red Chili ($40)                                                               

Chile Verde ($20)                 

Salsa ($15)                 

Make all checks payable to: Christian County Fair Chili Cook Off.