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Little Miss/Mr.

Sumner Application 2017


Applications due by June 12th

Name: ___________________________________________________Age: _____(Must be between 4-7)

Guardian/Parents: _____________________________________________________________________

Address: __________________________________________Phone Number: ______________________

Sponsor ($50.00/checks payable to CEO Sumner): ____________________________________________

Please include a 4x6 or smaller photo

Siblings: _____________________________________________________________________________

Hobbies/Interests:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Fun things I hope to do this summer:


_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

What I love about my town, Sumner:


_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Applications can be mailed to: Questions can be directed to:

CEO Sumner Kari Kelly

PO Box 262 (563)920-9169

Sumner, IA 50674 kl_kelly@live.com

Guardian/Parent Signature: ______________________________________________________________

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