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* 1. Student Name

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* 2. Parent/Guardian Name

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* 3. Street Address

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* 4. County

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* 5. Student Phone Number

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* 6. Parent Phone Number

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* 9. Preferred Method of Contact (please select one)

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* 10. School/Club

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* 11. Grade

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* 12. Do you have any immediate family members in the Florida citrus industry? (This will not affect your acceptance into the competition in any way.)

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* 13. If yes, what is their name and relation to you?

Any questions regarding the application or participation should be directed to Melanie Burns at 863-682-1116 or melanieb@flcitrusmutual.com.

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