Registry Form

Official Application for 2008 - 2009

Fill out the form below or you can use the

Step one: A recent clear photo must be sent to us for your application to be considered.

Step Two: Fill out application below and hit Submit

You will be emailed if you are accepted to represent your local area in the state competition either by a live pageant or internet competition.

Entering your state of:
*Name:*
Address:
City:
State:
*Zip Code:*
Birth date (mm/dd/yy)
Age
1St Email Address:
2nd Email Address:
Home Phone
*What County in your town do you live in?*

I am entering the division for:

(Please Check Only One)

Miss Teen- 14yrs to 17yrs

Miss 18 years and Up ( MUST HAVE NEVER BEEN MARRIED)

Mrs.- 18yrs and Up( MUST BEEN LEGALLY MARRIED)
Ms.- 18yrs and Up ( SINGLE MOTHER, DIVORCEE, OR WIDOWED)

Check the ones that apply....

I want a Local title only
I am competing for my state to go to nationals 2009
I am interested in the At-large title for state to go to Nationals 2009

Physical Attributes

Eye Color:		Height:		Jean size:
Hair Color:		Shoe Size:		Shirt Size:

Tell Us All About Yourself

1. Interesting information about me:

2. My community involvement:

3.Occupation or school information (hobbies):

4. Career Ambition:

5. What is your platform and why?

(Breast Cancer, S.I.D.S, D.A.R.E., March of Dimes, Etc.)

6) Favorite TV Shows:

7) Favorite Food:

8) Favorite Wardrobe Accessory:

9) Pets:

10) Secret Dream:

11) The one thing I can’t live without :

12) If I could change anything about myself :

Where did you hear about us?

PLEASE REMEMBER NO APPLICATION WILL BE PROCESSED UNTIL

WE RECEIVE YOUR PHOTO

You will be contacted soon on your placement.