Miss Black USA - Scholarship Pageant

Miss Black USA Talented Teen Pageant 2009

Win a $5,000 Cash Scholarship

Enter Today!

This online application will not be processed without the accompanying $50.00 application fee and photo. Please email photo to: info@missblackusa.org. $50.00 application fee may be paid by clicking here.

Online Application

Name:	Date of Birth:
Street Address:
City:	State: Zip:
Home Phone:
Message Phone:
Email:
I wish to apply to represent:
I certify that I in this state.

Pageants Previously Entered (Titles, if any):
School or University:
Employer:
Education level and all degrees received:
GPA:
Parent or Guardian if under 18:
Are you currently under any contracts at the present?
If you selected "Yes" above, please explain:
What is your platform?
What is your talent/talents?
How did you hear about this pageant?

I authorize the verification of the information provided on this form. I certify that I am a single (unmarried) female, was born female gender, between the ages of 13 and 17, and I am eligible to compete for the title of Miss Black USA Pageant. You must be 13 and no older than 17 by the date of competition, July 2009. Note: Your online application will not be processed without payment of the $50 non-refundable application fee.
Print Name:	Date:
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