Prelim Application for Junior - Mrs.
Miss ______________________ Palm Pageant
APPLICATION FOR JUNIOR 10-12, TEEN AGES 13 TO 16, MISS AGES 17 TO 23, Mrs 21-up & Married
(MUST SUBMIT ORIGINAL APPLICATION PLUS 4 COPIES FOR THE JUDGES)
FULL NAME ___________________________________________________________________________________
PREFERED NAME _____________________________________BIRTHDAY ____________________ AGE ______
PARENTS NAMES ______________________________SPONSORED BY _________________________________
HOME MAILING ADDRESS ________________________________________CITY __________________________
STATE _______ZIP ________ E-MAIL ______________________________PHONE # (______) ________________
SCHOOL _______________________________CITY ______________________STATE ______ZIP ____________
or
COLLEGE ______________________________CITY ______________________STATE ______ZIP ____________
COLLEGE MAJOR _________________________________STATUS/GRADE _____________ GPA ____________
PLATFORM SPEECH SUBJECT __________________________________________________________________
ORGANIZATIONS ______________________________________________________________________________
_____________________________________________________________________________________________
HONORS _____________________________________________________________________________________
_____________________________________________________________________________________________
SPECIAL TRAINING ___________________________________________________________________________
CURRENT OCCUPATION ___________________________FAVORITE HOBBY ____________________________
PREVIOUS TITLES ____________________________________________________________________________
CURRENT TITLES _____________________________________________________________________________
FAVORITE CHARITY ____________________________________________________________________________
MOST VALUABLE LESSON LEARNED IN LIFE ______________________________________________________
______________________________________________________________________________________________
HOW DO YOU INTEND TO USE YOUR COMMUNICATION SKILLS AS MISS _____________Palm: _____________
______________________________________________________________________________________________
WHY DID YOU ENTER THIS PAGEANT: ____________________________________________________________
_____________________________________________________________________________________________
WHAT IS YOUR GOAL IN LIFE ___________________________________________________________________
_____________________________________________________________________________________________
ADDITIONAL INFORMATION ____________________________________________________________________
Registration Entry Fee is $50.00 & must be postmarked by TBA & must include application, all money, ad & photos.
MY ENTRY FEE IS: ___$50.00___
I AM ENTERING THE FOLLOWING OPTIONALS AT $10.00 EACH! OR ALL 7 FOR $50.00.
_______ 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 with Photo for program (MANDATORY) from all contestants) $ ___$25.00___ .
Please insure you email your photo for the best quality for the program.
IF COMPETING FOR MISS ______________TROPICAL PALM MODEL QUEEN $30.00 $ ___________ OPTIONAL
IF COMPETING FOR MISS ______________TROPICAL PALM SWIMWEAR QUEEN $30.00 $ ___________ OPTIONAL
ENTER BOTH SWIMWEAR & MODELING FOR $50.00 $ ____________
SUPER SAVER ENTRY OF EVERYTHING ABOVE $150.00 ___________
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 PRELIMINARY PAGEANT I AM ENTERING, MISS FLORIDA PALM STATE 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 THE PRELIMINARY PAGEANT I AM ENTERING, AND THE MISS FLORIDA PALM STATE PAGEANT TO USE
MY DAUGHTERS PICTURE FOR PUBLICITY, ADVERTISEMENT AND PROMOTING THE PAGEANT SYSTEM.
PLEASE SIGN BELOW.
____________ ______________________________ ____________________________
DATE PARENT OR LEGAL GUARDIAN CONTESTANT
Return Signed Application to: Director
Phone# Email:
Make Checks payable to:
Send Application to:
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