2022 NJ NY Delegate Payment Form

2022 Ultimate International Miss NJ & NY Payment Form

Please carefully fill out this form to submit any remaining payments for the 2022 Ultimate International Miss New Jersey & New York State Pageant.
Delegate's Name*

First NameLast Name
Parent/Guardian's Name (if delegate under age 18)

First NameLast Name
State*
You may compete in any state you live or attend school in.
Division *
Age divisions are as of January 1, 2022.

Entry Fees

Ultimate International Miss State Full Sponsorship

Please add this option if you wish to pay your entire sponsorship fee.

$195.00

Ultimate International Miss State Half Sponsorship

Please add this option if you wish to pay half of your sponsorship fee.

$97.50

Casual Wear Entry

Please add this option if you wish to pay your entry fee for this optional competition. You may also pay for optional competitions at pageant check-in.

$35.00

Talent Entry

Please add this option if you wish to pay your entry fee for this optional competition. You may also pay for optional competitions at pageant check-in.

$35.00

Fitness & Lifestyle Entry

Please add this option if you wish to pay your entry fee for this optional competition. You may also pay for optional competitions at pageant check-in.

$35.00

Print Model Entry

Please add this option if you wish to pay your entry fee for this optional competition. You may also pay for optional competitions at pageant check-in.

$35.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

2022 Ultimate International Miss NJ & NY Payment Form