AMERICA'S NATIONAL PAGEANT
ONLINE APPLICATION CLICK ARROW TO SELECT DIVISION:    

Contestant First Name Only:      Date of Birth:
Age at time of this pageant:      Home Phone:
Complete Mailing Address:
                                          City:     State:      Zip Code:
Parents Names (if minor):      Email:
Hobbies & Special Intrest:
Ambition for Future:

FREE FUN PARTY
WITH MUSIC, GAMES,
AND PRIZES
 
Saturday 7-10pm
 
*** If you need a hotel room BOOK ASAP (860)635-2000 ***
 
You do NOT need to compete in ANY Optional Events in order to WIN Pageant Titles & High Point Queen.
 
Where did you hear of this pageant?
(mailing, advertisment, a friend, etc.)
 
We hereby have read and understand all the RULES & REGULATIONS set forth by the pageant and release the Directors and Staff from any and all claims for damages or for injuries we may sustain while participating in any of the pageant activities.
We affirm that all information on this form is true & correct
(Parents must sign - if contestant is under 18 years of age)


Parent Signature                                                   Date


Contestant Signature                                             Date
 
NOTE:
Applications recieved after the 2 week deadline
A $25.00 late fee may be charged.

Any Questions Call: (203) 922-1066
or Email: CoutoPageants@aol.com
SPONSORS are businesses or individuals who can pay your entry fees. This may be parents, friends or businesses. Remember that you can sponsor yourself if you wish!!! Up to 5 sponsors names will be announced during the pageant. This is a tax deduction for any business.

SPONSOR'S NAMES - if any (will be mentioned during pageant):
 
SPONSOR ENTRY FEES
ONE PAGEANT -
BOTH PAGEANTS -
OPTIONALS
PHOTOGENTIC          GLITZ - $25 each
NATURAL - $25 each
MODELING   GLITZ/Pro/Am - $50 each
NATURAL RUNWAY - $50 each
TALENT                                  - $60 each
PAIRS MODELING         - $70 per pair
TOTAL
TOTAL ENCLOSED
 
PayPal Accepted:
CoutoPageants@aol.com

OR MAIL A CHECK TO: America's National Pageant
P.O. BOX 556, SHELTON, CT 06484
 
IMPORTANT
Registration From with at least with $100 Deposit MUST BE RECIEVED
IN PAGEANT OFFICE BY 2 Weeks Prior to event
NOTE: Any Applications recieved within that 2 weeks may be subject to a 25.00 late fee