Empowerment Academy Signature Program Application
Date of birth
Social media handles
Personal or business website
What is your highest level of education received?
List pageant systems in which you have participated:
Are you registered or have plan to register for a pageant or major life goal within the next year? If so, list dates and details here.
List titles and awards received:
If you were referred to the program, please list their name here:
What are your talents (performance and non-performance)?
What are your pageant and/or life goals for the next 6-12 months?
Why do you want to become an Empowerment Academy Signature Program Delegate?
Please describe any accommodations you may need:
Name of parent or legal guardian (if under the age of 18)
Contractual Agreement for Participation
I have read the Contractual Agreement for Participation, and agree to abide by the rules as set forth by the Empowerment Academy. I will pay the $350 registration fee via Venmo to @Darcy-Castro promptly.
Should be Empty: