2026 Junior Promoter Annual Application

2026 Junior Promoter Application

*Junior Representatives should plan to attend Western or Eastern Mini-Seminar with your county: June 16 or June 17th, respectively. Both will have the same program. We encourage you to join with your county program. If you are unable to attend Mini-Seminar, please provide a written note to PDPPS Board Member or office and please plan to attend Fall Training on November 14.
County*
Role*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Birthday*

MonthDayYear
Date
Age (As of 6/1/2026)*
Years in Dairy Promotion program
Grade in School for Fall 2026
Mother's Name*

First NameLast Name
Father's Name*

First NameLast Name
Parents Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Cell Phone (if different from above)

Area CodePhone Number
Own Dairy CattleDairy Farmer's ChildRelated to Dairy Farmer/IndustryFamily member manages/works on a dairy farmOther
As the Junior Dairy Promoter and Parent/Guardian, I have read the PDPPS Code of Conduct (found on the Member's Only section of the website and in the Dairy Princess Program Handbook), Dress Code and Program Handbook. I will carry out my responsibilities in accordance with the Pennsylvania Dairy Princess & Promotion Services, Inc. policies and I understand that my title may be removed if I do not satisfactorily follow these established standards. I (we), consent that from this day forward Pennsylvania Dairy Princess and Promotion Services, Inc. has full rights to release and publish all photographs of me in which the participant listed above appears in connection with his/her activities in the Pennsylvania Dairy Princess Program without any compensation to us, either now or in the future.*

I agree
Signature of Participant*

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Signature of Parent/Guardian completing this application*

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Please state any known allergies to medication, food allergies, or gluten intolerance*
Please state any medications taken regularly (include doses)
Please list any medical conditions
Please list Family Doctor's (please leave out Dr./Mrs./Mr.) Name, Address, and Phone Number:
Should be Empty:

2026 Junior Promoter Application