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| Official Contest Name: |
| Contest Location (Street Address): |
| Contest Location (City & State): |
| Event held in conjunction with: |
| Contest dates: |
| Contest Organizer: |
| Organizer Mailing Address: |
| Telephone (Day): |
| Telephone (Night): |
| Fax: |
| E-mail address: |
| Please describe your interest in FBA sanctioning: |
| How did you hear of the FBA? |
| Organization Official |
| Date |
The Florida BBQ Association
11161 Sandyshell Way
Boca Raton, FL 33498