Contestant Application

Saturday, October 5th, 2019
Clinton Presidential Center
Little Rock, Arkansas


In order to reserve your space, please complete the application to the right.

For easier data entry, the form may completed on-screen within Acrobat and printed.

Deposit and fees

Entry Donation – Your entry donation and hard work help Harmony Health Clinic provide medical care to the homeless, uninsured, and veteran populations in Central Arkansas

Professional and Amateur teams – $100.00 entry donation

Pay donation online:

Use the Central Arkansas Ticket link ( and select Professional or Amateur competitor from the drop down ticket options.

Make check or money order payable to:

World Cheese Dip Competition


Send application and donation to:
Harmony Health Clinic
201 East Roosevelt Road
Little Rock, AR 72206


Fill out my online form.