Southeastern  Pennsylvania Regional Competition

Student Information

Name of Individual or Group Leader (Will register for group on day of competition)
First Name	Last Name	Middle Initial
Address
City	Zip Code
Grade	Email	Home Phone
Parent Name		(555) 555-5555 format
Division
Junior (Gr. 6-8) Senior (Gr. 9-12)
Category
Individual Exhibit Individual Documentary Individual Performance   Group Exhibit Group Documentary
Group Performance Historical Paper Website
Please list other group members
Entry Title
School Information
School Name
Address
City	Zip Code
Sponsoring Teacher Name
Teacher Email	Phone
	(555) 555-5555 format
State Representative District	State Senatorial District
Name of Local Newspaper
Additional Group Member Information
1. Name
Street
City	Zip Code
Grade	Home Phone
	(555) 555-5555 format
Email
Parent Name
2. Name
Street
City	Zip Code
Grade	Home Phone
	(555) 555-5555 format
Email
Parent Name
3. Name
Street
City	Zip Code
Grade	Home Phone
	(555) 555-5555 format
Email
Parent Name
4. Name
Street
City	Zip Code
Grade	Home Phone
	(555) 555-5555 format
Email
Parent Name