The Vietnam Learning Association - 2009 Ao Dai Calendar Official Entry Form

Instructions: Copy into either an email or word processing program and fill out completely. Return by email to: calendar2009@vietnamlearning.org, or mailed to:

Vietnam Learning Association
409 Third Street
Mebane, NC 27302

IMPORTANT: If you are under the age of 18 you must also attach permission from a parent or guardian to enter the contest.

PHOTOGRAPH: You must attach a copy of the photo you've submitted for the contest with your official entry form.

Last Name (family name):
Middle Name (or initial):
First Name:
Maiden Name:

Residential Street Address:
Apartment Number:
City:
State:
Zip Code:

Daytime Phone Number:
Cell Phone Number:
Evening Phone Number:
Email Address:
Alternate Email Address:
MySpace Address:

Date Of Birth:
Height:
Weight:

Essay (Tell us a bit about yourself and why you would like to be featured in our calendar; around 100-150 words.):