Contestant's name:

Age:        Birth date:

Parent/Guardian name:

Address:

City:   State:    Zip:

E-mail:
How did you hear about our pageant?

Tell us about the contestant. Why do you think she is special?
Why do you think she should be chosen as a Miss American Rose representative?
 

By checking here I understand that if she wins her city competition, she has the option to continue on to the next level of competition representing her state, but is not required to do so. All information on the application is accurate to the best of my knowledge. We promise to respect any title she is awarded and represent the Miss American Rose Pageant Royal Family with pride.

OPTIONALS:

Photogenics:
I wish to enter her in the Photogenic optional.
    I will send her picture(s) by postal mail.
    I will e-mail her picture(s) miss@americanrose.com

Achievement:
I wish to enter her in the Achievement optional.
    I will send her Achievement entry by postal mail.    
   I will send her Achievement entry by e-mail.
   I am using the space below to tell you about her achievements. I understand they may be achievements through talent, education, community service, or any other area of her life. I also understand the judges will take her age into consideration.

I wish to enter (contestant)  in the
Teeny Miss competition(0-2)
Tiny Miss competition (3-5)

Representing:
1^st choice city , (state)
2^nd choice city, (state)

  Check one: (See Prizes & Rules for more info)
  Regular prizes - $30 - Optional competitions $10
  Classic prizes - $40  - Optional competitions $11
  Deluxe prizes - $55  - Optional competitions $13

I have added $10 to receive a Deluxe tiara instead of the Classic tiara

Check any optionals she is entering:
Photogenic Optional 
Achievement Optional
I understand that by entering at least one optional she will also be eligible for the City Queen title.  

+ $5.00 - required 2008 shipping surcharge (effective 10/21/07)

Entry Fees:
Total amount to be submitted $
I will be sending her entry fee through PayPal
I will be sending her entry fee by postal  mail.

Send any additional materials by postal mail to
Miss American Rose
19689 7^TH Ave. NE, PMB 323
Poulsbo, WA  98370

or by e-mail to miss@americanrose.com

Comments:

When you are done, click the submit button.
We will e-mail you to let you know your entry was received We will give you your pageant date when your entry fee is received.