City
Email
Date of Birth
Zip Code
Street Address
Parents Name
State
.First Name
Last Name
Details
Middle Name
Home Phone
Applicant Grade Level
Age Division
Grade Point Average
*Age groups are assigned by the contestant's attained age as of January 1 of the year of the competition
School and Community Activities, Awards, Talents, Hobbies, etc.:
In the box below next to the white arrow inside the red circle, list activities in order of importance - most recent and most important first. Use outline form. Give year of activity or award, if possible. You may list your activities for the past five years.   

Please list all of your accomplishments
Cell Phone
     Age Today
College
A $125.00  Registration Fee and  must be submitted with your application                                                                        
Registration and Sponsorship Fees are NON-REFUNDABLE                                     
Credit Card
Name on Card
Billing Address
Date
Once we receive your application, you will be provided a personalized PIN NUMBER and full access to the "Contestants Only Section" to submit your Secure Online Payments for your Sponsorship Fee,  Required Ticket Sales and more.   
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If referred by a friend, whom may we thank?
Please TYPE In which city title you would like      MISS
Second Choice if the first city title is not available MISS
       2019  OFFICIAL  STATE  APPLICATION
Legal First Name
Middle Name
Last Name
    Birth Date
City
Home Address
Zip Code
Parent(s) or Legal Guardian Name(s) if UNDER age 18
Email Address
Facebook Name
Home Phone

We invite all women between the ages of 31 and 24 as of January 1, 2019 for The Pageant Ms. International USA, women at least between the ages of 27 and 19 as of January 1, 2019 for The Pageant Miss International USA, and young women at least between the ages of 18 to 14 for The Pageant Miss International Teen USA.  To apply, please complete the application below.  Once you have completely filled out your application,  please click:  SUBMIT MY APPLICATION button at the bottom of the page for transmission.  Thank you!


Area Code
Phone
(your phone number associated with this card)
 3 to 4 digit Security Code on back of card
What state do you live in?
Type Here
                      Ms.   Miss    Teen   
   T Shirt Size
Dress Size
Swim Top
Swim Bottom
All contestants will be provided with their Official State Sponsorship Letter once they have paid their Registration Fee!
T H E  P A G E A N T   INTERNATIONAL U. S. A.
State Application
OFFICIAL APPLICATION
(Please include city, state and zip code associated with this card)
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THE  PAGEANT  INTERNATIONAL U.S.A, Inc.
Black Diamond Entertainment Inc.
All Rights Reserved 2018
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