CHILIMANIA COOKER'S
ENTRY FORM

Print, complete and mail this form with $20 to:

Chilimania Inc.
614 Hemphill Avenue
Edgerton, WI  53534

Name _________________________________________________

Street _________________________________________________

City, State, Zip __________________________________________

Phone & Area Code ______________________________________

Circle all categories that apply:

CASI   --   TRADITIONAL    --   SALSA