MISS NORTHEAST ® Pageant
ONLINE APPLICATION CLICK ARROW to SELECT DIVISION:

Contestant Name:      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:

Our Queens have a FUN and EXCITING Year!
 
If you would like info on being a VENDOR at the EXPO on
same day contact Christina: coutopageants@aol.com
 
We hereby have read and understand 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
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 4 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):
 
Where did you hear of this pageant?
(mailing, advertisment, a friend, etc.)
 
SPONSOR ENTRY FEES
PAGEANT (Past Couto Contestants)-
PAGEANT (NON Past Contestants)-
OPTIONAL EVENTS OFFERED
PHOTOGENTIC - $25 each
MODELING - $50 each
HOLIDAY WEAR - $50 each
TALENT - $50 each
TOTAL ENCLOSED

 Paypal accepted - COUTOPAGEANTS@AOL.COM

 
IMPORTANT
Registration Form with Pageant PAYMENT MUST BE
IN PAGEANT OFFICE NO LATER THAN
5 DAYS PRIOR TO EVENT
NOTE: Applications recieved within that 5 days may be subject to a $25 late fee