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NAME:________________________________________________________________
ADDRESS______________________
AGE:_____DATE OF BIRTH:__________PLACE OF BIRTH:________________
COLOR OF HAIR:________ COLOR OF EYES:________________
HEIGHT:___ WEIGHT__ _BUST:___ WAIST:___HIPS:_______________
DRESS SIZE:______ SHOE SIZE:_____SWIMSUIT SIZE:_______________
EMAIL ADDRESS:__________________TEL NO. (HOME):_____________________
CELL:____________ OCCUPATION:_________________________________
EMPLOYER________________________________________
WHAT ARE YOUR HOBBIES?____________________________________________________
LANGUAGES SPOKEN FLUENTLY:______________________________________
FAVORITE FOOD_______SPORT:________ACTOR:____________
ACTRESS:_____SINGER:________SONG:_________
FAVORITE VACATION SPOT__________________________________________________________
Talent:_______________________________________________________________
List any other special talent skills: _____________________________________________
Have you participated in any beauty pageants?___________________________________________
PASSPORT NO.: ______________________________
DATE OF ISSUE:____________DATE OF EXPIRE____________________________
WHAT IS YOUR LIFE AMBITION?
_____________________________________________________________________________
Signatures Required Candidate_______________________________
Dated this ___________ day of ______________ in the year _____________,
EVERY QUESTION MUST BE ANSWERED,,,,,DO NOT LEAVE ANY BLANKS
If you cannot download this form please print it out, complete the form and mail ASAP
with your deposit and photographs
I confirm that above information is correct and that my entry into the Miss Palm Springs USA pageant is through my own Choice.
1. Please complete the form completely and send it back ASAP.
2. Please also send full length color photos of the contestant 5x7 / 8x10
(2 portraits,Head / shoulder with a plain background (No hates - No crowns}
Madlin's Agency 2688 E. Julian Road Palm Springs, Ca. 92262
Email: MissIntPgt@aol.com
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