Speech Contest Entry Form

Rotary District 7610

Speech Contest Entry Form

Speech Theme:

Rotary Making a Difference

Student Name: ______

Home Address: ______

Home Phone: ______Cell: ______

School/Grade: ______

Teacher/Coach: ______

E-mail address: ______

If selected as winner (or alternate) in the club contest, I will be available to advance to the Area level of competition in March (date, time and location to be announced). If selected as the winner (or alternate) of the Area contest, I will be available to speak at the Final Speech Contest on Saturday, April 7, 2018 at a location to be announced near Fredericksburg VA. If selected as the District winner, I will be available to speak at the District Conference on Saturday, April 28, 2018. If I am unable to make this presentation, I understand that I will forfeit the first place winner designation and award.

I agree to abide by the rules of the Rotary District 7610 Speech Contest and to create and present an original speech (without using notes, props or prompts). I understand my parents are invited to attend each level of competition and that a Rotarian from my sponsoring club will make arrangements for me.

______

Student’s Signature Date

Return to your local Rotary Club and the club will schedule a speech contest to select the best speech to forward for consideration at the next level of the contest.

Sponsoring Rotary Club: ______

Sponsoring Rotary Club Point of Contact: ______

Sponsoring Rotary Club Contact Information: ______

______

Sponsoring Rotary Club President Signature Date

This entry form should be submitted to the Youth Contest Chair, Holly Graf at by March 30, 2018 for each entry in the District Contest scheduled on April 7, 2018. The entry form should be submitted by the respective Club / Area Governor after the Area Speech Contest is completed.

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