Juneteenth Wylie Scholarship Pageant Inquiry Form

We’re excited to celebrate and uplift the next generation of young leaders! This form helps us gather important details about potential participants to ensure a smooth registration process. Please provide accurate information so we can keep you updated on pageant details, eligibility requirements, and next steps.

Thank You for Your Interest in the Juneteenth of Wylie Scholarship Pageant!

*Submitting this form does not guarantee registration, but we will follow up with more details on how to officially sign up.

Participant's First Name *

Participant's Last Name *

Participant's Date of Birth (MM/DD/YYYY) *

Participant's Age As Of May 1, 2025 *

Participant's Grade *

Participant's School Name *

How did you hear about the Juneteenth of Wylie Scholarship Pageant? *

Does the participant have any allergies or medical conditions we should be aware of? *

Participant's T-shirt Size *

First Name *

Last Name *

Phone *

Email *

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