2020 Miss CEO Jr. Divsion Application

2020 Miss CEO Jr. Division Application

Ages 5 -13
Application is open until midnight 3/14/2020!
Miss CEO Mission: Cultivate the minds of young ladies to obtain leadership positions and leverage their status to empower other women to be successful in their career endeavors.

Miss CEO Vission: From the classroom to the boardroom, leaving a legacy of opening the door for others.
Student Name*

First NameMiddle InitialLast Name
Birth Date*

MonthDayYear
Age
School Attending
Grade
T-Shirt Size (i.e. Small, Medium, Large, X-Large, Youth or Adult)*
Race:*

American Indian/Alaskan NativeAsianBlack or African AmericanNative Hawaiian/Other Pacific IslanderCacusainHispanic or Latino originMultiracial
Home Phone*

Area CodePhone Number
Parent/Guardian Cell Phone*

Area CodePhone Number
E-mail Address*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What are your Education and Career goals/ What is your dream career?
What are your hobbies and interests?
What business or charity have you created?
Why do you (parent why do you want your child) want to be in the ICIBE Miss CEO Scholarship Series Showcase, and what experience do you hope to gain from your participation?
What do you know about the Indianapolis Chapter Black Expo?
4x6 Head Shot*

Browse Files
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Recommendation Information

must be non related
Name *

PrefixFirst NameLast Name
Phone Number*

Area CodePhone Number
E-mail Address*
example@example.com

Parent(s) Section

Parent or legal guardian
IF AT ANY TIME IT IS ASCERTAINED THAT THE CONTESTANT IS IN VIOLATION OF THE ICIBE MISS CEO SCHOLARSHIP SERIES SHOWCASE RULE AND REGULATIONS, THEN IT IS UNDERSTOOD THAT THE CONTESTANT MAY BE DISQUALIFIED!
Parent/Guardian Name 1

First NameLast Name
E-mail Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Parent/Guardian Name 2

First NameLast Name
E-mail Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number

APPLICATION CHECKLIST (Incomplete application will not be processed)

Completed Application4x6 Head shot$125.00 Assessment Fee (Non-Refundable)Recommendation Contact Information (Must not be related to the contestant)
Assessment Fee (Includes fee for Miss CEO apparel)*

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2020 Miss CEO Jr. Division Application

Recommendation Information

Parent(s) Section