Empowerment Academy Application
Name
First Name
Last Name
Age
Date of birth
Mailing address
City, State, Zip
Email
Phone
Social media handles
Website
Name of parent or legal guardian (if under the age of 18)
What is your highest level of education received?
List pageant systems in which you have participated:
List titles and awards received:
Are you currently under a non-compete contract with another pageant system? (No worries, we can work around this!)
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 Delegate?
Please describe any accommodations you may need:
Submit
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