NAME OF CONTESTANT
Last First
PARENT’S NAME (IF CONTESTANT IS UNDER 18)
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 your score will be based on how you answer the following interview questions.

1. What goals would you like to accomplish in the next year?

2. What goals would you like to accomplish in the next 5 years?

3. What is the best lesson you have learned in your lifetime?

4. What 3 words best describe you?


5. If you could have any job, what would it be, why?


6. What is the greatest thing you have accomplished in your life?


7. What is the most important thing you hope to accomplish in your lifetime?

8. What person do you admire most, why?

9. Why do you want to win the title Miss World Rose?

10. If you win, what do you plan to do with your title?


40% of your score will be based on one of the following areas of competition.
Which area do you wish to compete in? Only one optional 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, sewing, photography, etc. you may send photos of your talent. Please send a brief essay telling us about your talent and what you have accomplished.
Lifetime Accomplishments - Please send a list or essay telling us what you have accomplished in your lifetime. This may have to do with a career, volunteer work, awards you have won, etc. You may also attach copies of any certificates or other supporting documentation.
Photogenics - Please send 1-4 photos of yourself taken within the last 2 years.

By submitting this entry, I swear that all information is true and correct to the best of my knowledge
I certify that I am of good moral character.
I promise to respect any title I may be awarded and represent this pageant system with pride.
I have read and understand all information.
I understand that I will not be awarded any cash prizes unless I submit a photo of myself in my crown and banner within 45 days of receiving my 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.

$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 a second optional competition

Fees will be submitted 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 video) don't forget to mail them to Miss American Rose, 19689 7th Ave. NE, PMB 323, Poulsbo, WA  98370

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