International Junior Miss - Registration Form

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International Registration Form

Instructions:

Complete the registration form, read and acknowledge the International Junior Finals Release Form Below.
Mail a recent snapshot (need not be professional and will not be returned) or email us at photo@internationaljrmiss.com. Please include your name and state in the subject line.
Additional information will be sent to you within 10 days of receipt of your Entry Form.


Name:
Email Address:
Verify Email Address:
Choose your Division:
	Age divisions are determined by the applicant’s age between April 1, 2011 and July 1, 2011.
Parent’s Name (if under 18):
Date of Birth:
Street Address:
City:
State:
Zip Code:
Phone:
School:
Grade:
Hobbies & Interest:
Clubs & Organization:

International Pageant COMPETITION	$495.00 International Pageant Registration Includes all areas of QUALIFYING COMPETITIONS.

By submitting this form, you agree that you have read and understand the rules and regulations governing the International Junior Miss State & International Scholarship Program. Please print a copy of the rules and regulations agreement for your records.