* 2. Contestant Name

* 3. Address, City, City, State, Zip

* 4. Primary Telephone Number / Cell Phone Number

* 5. How man CMNH Hours have your worked/CMNH Donations Monies Raised  (Ex. Children Miracle Network Dairy Queen, CMNH Hospital visitation, Promoting CMNH in anyway) 

* 6. Community Service Project Name (Name of Your Platform)

* 7. Your Community Service Project (Platform) Hours

* 8. Community Service Amount Raised  (Total Amount of money you have raised in the past year with your platform)