Public Speaking Contest Entry Form

THEODORE ROOSEVELT PUBLIC SPEAKING CONTEST

ENTRY FORM

Name and Address of High School________________________________________________

_____________________________________________________________________________

School Telephone Number ______________________________________________________

Name of Contestant ___________________________________________________________

Contestant's Address _________________________________________________________

____________________________________________________________________________

Contestant's Phone Number ____________________________________________________

Contestant's E-Mail ___________________________________________________________

Contestant's Grade (Circle) 9 10 11 12

Teacher/Coach Name_________________________________________________________

Title _______________________________________________________________________

Teacher/Coach Telephone _____________________________________________________

Teacher/Coach E-Mail ________________________________________________________

Principal/ Headmaster ________________________________________________________

Supervising Chairperson _______________________________Dept.___________________

Please return this form on or before Friday, February 6, 2009 to:

Mark Lozo

Theodore Roosevelt Inaugural National Historic Site

641 Delaware Avenue

Buffalo, NY 14202

Home school students may contact the Theodore Roosevelt Inaugural Siteif they have questions regarding filling out this form.

Last updated: February 26, 2015

Contact the Park

Mailing Address:

Theodore Roosevelt Inaugural Site
641 Delaware Avenue

Buffalo, NY 14202

Phone:

(716) 884-0095

Contact Us