2011 Miss Florida Palm State Scholarship Pageant tm
APPLICATION FOR JUNIOR AGES 10-12, TEEN AGES 13 TO 16, MISS AGES 17 TO 23, Mrs 21-up and/or Married
(MUST SUBMIT ORIGINAL APPLICATION PLUS 4 COPIES FOR THE JUDGES)
FULL NAME ________________________________________BIRTHDAY ___________________ AGE ______
SPONSORED BY ______________________________ PARENTS NAMES _____________________________
REPRESENTING _____________________________________________________________________________
ADDRESS _______________________________________CITY _________________ STATE _____ZIP ________
E-MAIL ______________________________________________________PHONE # (______) ________________
SCHOOL _______________________________CITY ____________________ GRADE _________ GPA _______
COLLEGE _____________________________ MAJOR ___________________GRADE _________ GPA _______
PLATFORM SUBJECT _________________________________________________________________________
ORGANIZATIONS _____________________________________________________________________________
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HONORS ____________________________________________________________________________________
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SPECIAL TRAINING __________________________________________________________________________
CURRENT OCCUPATION ______________________________________________________________________
FAVORITE HOBBY ___________________________________________________________________________
PREVIOUS or CURRENT TITLES ________________________________________________________________
FAVORITE CHARITY ___________________________________________________________________________
COMMUNITY SERVICE _________________________________________________________________________
MOST VALUABLE LESSON LEARNED IN LIFE _____________________________________________________
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HOW DO YOU INTEND TO PROMOTE THE MISS FLORIDA PALM PAGEANT IN FLORIDA: ________________
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WHY YOU ENTERED THIS PAGEANT: ____________________________________________________________
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WHERE DO YOU SEE YOURSELF IN 10 YEARS ____________________________________________________
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ADDITIONAL INFORMATION ____________________________________________________________________
Entry fee is $150.00 for at Large Contestants & must be postmarked on or before 01 July 2011.
Entry Fee is $150.00 for Local & Regional Palm Queens ($75.00 paid by Contestant & $75.00 Paid by Director).
Entry fee for Prelim Pageant Queens is $100.00. (Paid by Contestant). ie Firecracker, Pumkin Princess, Sunshine,
Relay for Life, Emerald Coast Our Little Miss, Etc.
Entry is $125.00 for Queens of any other Pageant within Florida. Add $25.00 for late entries until 15 July 2011.
All Entries must include Application, all money, ads (Ready to be copied), music CD's & photos.
MY ENTRY FEE IS: _______________
I AM ENTERING THE FOLLOWING OPTIONALS AT $15.00 EACH! OR ALL 7 FOR $75.00.
_______ PRETIEST SMILE _______ PRETTIEST EYES _______ BEST ATTIRE _______ PRETTIEST HAIR
_______PRETTIEST FACE _______ BEST PERSONALITY _______ PHOTOGENIC - AT $10.00 EXTRA FOR EACH. UP TO 4.
(OPTIONALS) = $ _______
ONE $25.00 GOOD LUCK AD (MANDATORY) $ _______ . Include you 15 words of Good Luck written below photo from Family, Friends or Business.
IF COMPETING FOR LITTLE MISS FLORIDA TROPICAL PALM STATE QUEEN TITLE (TALENT) $50.00 $ ________ OPTIONAL
IF COMPETING FOR LITTLE MISS FLORIDA TROPICAL PALM STATE QUEEN TITLE (SWIMWEAR) $50.00 $ ________ OPTIONAL
IF COMPETING FOR LITTLE MISS FLORIDA TROPICAL PALM STATE QUEEN TITLE (MODEL) $50.00 $ ________ OPTIONAL
SUPER SAVINGS DISCOUNT ON ENTRY! ENTER EVERYTHING ABOVE FOR $300.00 _________
PROGRAM BOOK $15.00 $ __________ OPTIONAL
PHOTO CD WITH ALL PICTURES OF CONTESTANT $15.00 $ ___________ OPTIONAL
DVD OF PAGEANT $30.00 $___________ OPTIONAL (DVD & PHOTO CD) $40.00 $ __________ OPTIONAL (A $5.00 Savings)
PREPURCHASE PAGEANT ADMISSION TICKETS $8.00 ea. # of Tickets_______ Total $ __________
(Will be given out at Rehearsal) A $2.00 Savings Each.
TOTAL ENTRY FEE $ _______
I certify by my signature below, that I have read, understand and will comply with the Pageant rules and regulations
set forth below and on the pageant website at www.prowant.net rules and information page. CONTESTANTS AGREE
TO HOLD HARMLESS THE MISS FLORIDA PALM PAGEANT, THE DIRECTORS, THE VOLUNTEERS, THE LOCATION OF THE
PAGEANT AND ITS HOLDINGS FROM DAMAGES INCURRED THROUGH LOSS, THEFT, OR INJURY CAUSED BY OR DURING HER
PARTICIPATION OR TO AND FROM THE PAGEANT OR ANY RELATED EVENTS. I HEREBY ACKNOWLEDGE THAT I HAVE READ
THE OFFICIAL RULES AND REGULATIONS SET FORTH BY THE PAGEANT AND THAT I WILL COMPLY WITH THEM IN EVERY
WAY, AND THAT THE PERSONAL DATA THAT I HAVE SUBMITTED IS TRUE AND CORRECT. I GIVE PERMISSION FOR MISS
FLORIDA PALM STATE PAGEANT TO USE MY DAUGHTERS PICTURE FOR PUBLICITY.
PLEASE SIGN BELOW.
____________ ______________________________ ____________________________
DATE PARENT OR LEGAL GUARDIAN CONTESTANT
Return Signed Application to: Todd Prowant, Director
Make Checks payable to: Miss Florida Palm
Send Application to: Prowant's 10126 N.W. Prowant Ln., Clarksville, FL. 32430
Application Refered By: ________________________________________
Copyright © 2007-2010 Prowant's. All Rights Reserved.