NAME OF CONTESTANT 
Last First
PARENT’S/CONTACT NAME
Last First

ADDRESS1
ADDRESS2
CITYSTATE/PROVINCEZIP
AGE (as of June 21st, 2010)
BIRTHDATE (MM/DD/YY)
E-MAIL
HOW DID YOU HEAR ABOUT THIS COMPETITION?
Country you wish to represent
2nd choice country
If you are a resident or citizen of more than one country, or if you are at least 25% a certain nationality, you may list that country as your 2nd choice for an additional $15
If you do not win a title in your first choice country you may compete in your 2nd choice's competition.

60% of  score will be based on essay written by an adult about the contestant.
Please answer the following questions the best you can in the essay.
Suggested length is 100-250 words.
Why do you think this contestant should be awarded a Miss World Rose title?
What would she do with her title?
What are her goals, or what are your goals for her?
You may add anything you wish to tell us about the contestant.



40% of  score will be based on one of the following areas of competition.
Which area do you wish to compete in? Only one optional competition is required and is included in the basic entry fee. If you wish you may enter a second optional competition for $10, but only your highest scoring optional will be added to your final score.
The following may be sent via snail mail or e-mail  when possible.

Talent - If your talent is some sort of performing (singing, dancing, acting), please send a CD or DVD. If you have a talent such as drawing, painting, etc. you may send photos of your talent. Please send a brief essay telling us about your talent.
Lifetime Accomplishments - Please send a list or essay telling us what you have accomplished in your lifetime. This may have to do with a school, volunteer work, activities, etc. You may also attach copies of any certificates or other supporting documentation.
Photogenics - Please send 1-4 photos of contestant taken within the last year.

By submitting this entry, I swear that all information is true and correct to the best of my knowledge
I certify that the contestant and I are of good moral character.
We promise to respect any title she may be awarded and represent this pageant system with pride.
I have read and understand all information.
I understand that she will not be awarded any cash prizes unless I submit a photo of the contestant in her crown and banner within 45 days of receiving her prizes..
I understand there will be no refunds of entry fees.
I understand that any misrepresentation of myself may result in the loss of any title I am awarded.

I am submitting:
$60 entry fee.
$15 to have my prizes shipped outside the U.S.A.
$15 to be considered for the title of a second country.
$10 to enter additional optional competition.

Fees will be paid through PayPal
Fees will be sent via postal mail (to arrive by June 21st).

ALL FEES MUST BE SUBMITTED IN U.S. FUNDS MADE PAYABLE TO "MISS AMERICAN ROSE"
ENTRIES MUST BE RECEIVED BY JUNE 21st, 2010
SEND TO: MISS AMERICAN ROSE, 19689 7th Ave. NE, PMB 323, POULSBO, WA 98370, U.S.A.
OR
ENTRY FEE IS PAYABLE THRU PAYPAL.COM    Account: miss@americanrose.com Click on the icon below.

When you are finished, hit the submit button. If you have any additional materials to submit (like a talent dvd) don't forget to mail them to Miss American Rose, 19689 7th Ave. NE, PMB 323, Poulsbo, WA  98370, or send by e-mail to miss@americanrose.com

If you have problems submitting this form, you may send the same information via e-mail to miss@americanrose.com