Star Student Entry Form

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Your First Name:

Your last name:

Your email address:

Your phone number:

Your nominee's first name:

Your nominee's last name:

Their contact information:

Where do they go to school and what grade?:

Why should they be chosen?:

What do they do to improve their school or community?:

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Your registration information is for the use of KORQ-FM only. We collect information in order to keep you informed of contests and events sponsored or promoted by KORQ-FM. KORQ-FM will not sell, rent or in any way distribute personal information supplied to us by you. The information you provide us stays with KORQ-FM only.

Star Student Entry Form

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