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Are you ready to be a star? The Stuck at Prom Scholarship Contest® is a great way to have a blast with duct tape and have a shot at winning some cash for school (Up to $3,000 EACH!).
Name*
Address*
State* Select a State -----US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands of the U.S. Virginia Washington West Virginia Wisconsin Wyoming -----Canada Alberta British Columbia Labrador Manitoba New Brunswick Newfoundland Nova Scotia NW Territories Ontario Prince Edward Is Quebec Saskatchewan Yukon
Closest Major City*
Home Phone Number*
Cell Phone Number*
E-mail Address*
Name of High School*
Year in School*
Date of Prom (MM/DD/YYYY)*
Have you started work on your outfit?
If not, when do you anticipate starting? (MM/DD/YYYY)
Are you comfortable being contacted by television stations,radio stations and newspapers for interviews?
Any details of your outfit you'd like to share?Theme, colors, design, etc.