Apply for the New York & New Jersey: America's Perfect Jr. Teen,Teen, Miss & Woman Pageant

Please complete ALL of the information below to apply for this year's pageant.

First Name:

Last Name:

Street Address:

City:

State:

ZIP Code:

Date of Birth :

Age:

Phone Number:

Cell Phone:

Business Phone:

Occupation:

Email Address 1:

Eye Color:

Confirm Email Address:

Hair Color:

Height:

Dress Size:

Favorite Foods:

Shoe Size:

Honors and Awards:

Ambition:

Education:

Hobbies:

Talent, if any:

State Director:

AGE DIVISIONS:

Ages 10-12 years : Pre-Teen "New Division"

Ages 13-15 years : Junior Teen

Ages 16-19 years : Teen

Ages 20-29 years : Miss

Ages 30 years and beyond : Woman

Parent's Name(s):

Street Address:

City:

State:

ZIP Code:

ENTRY FEE:

Fees:
$595.00 – Entry Fee
$150 – Full Page Ad

Simply call in your credit card payment to: (917) 541-6739

New York & New Jersey State Director: Shiemicka Richardson-Banner

I hereby apply as an entrant in the state of:
An official preliminary to America’s Perfect Teen® and Miss® Beauty Pageant

Applicant's Name:

Parent or Guardian's Name: (if applicant is under 21)