Beauties of America

Your Name:

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Applicant's Name:

Age as of August 1, 2009:

Birthdate: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939    Birth Place :

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PAGEANT ENTRY FEE BONUS: Recommend one contestant that is a paid at large entry and receive a $25.00 credit, two - $50.00 credit, three - $75.00 credit, etc. Your name must appear in the space provided or they must mention your name the FIRST time they contact pageant headquarters.

Sign Application with Initials and Date:

How did you hear about us? (Select One) Pageantry Magazine TFTJ Web Site Savvy Magazine Supermodels Unlimited BOA Contestant Other

If there is not a preliminary pageant in your state, the national office will be selecting one state titleholder per decade.

If you wish to be considered for selection as an "at large" state delegate, simply print this application page and send with a photograph and a $35 processing fee to:
Beauties of America Pageant, LLC
PO Box 466 — Lebanon, Ohio 45036

I have read the official entry form and agree to be bound by the rules and regulations set forth. I hereby state that all information is true. Any misrepresentation will cause immediate disqualification. If selected as a delegate, applicant agrees to participate in the 2009 Beauties of America pageant and if crowned one of the decade winners, applicant agrees to sign a contract stating that she will make public appearances on behalf of the pageant. Applicant also agrees to return to the 2010 national pageant for the purpose of crowning her successor, if selected as a 2009 national queen. If applicant cannot fulfill these obligations, the title and all prizes earned will be presented to the first runner-up.