Miss Illinois Appearance Request Form

Thank you for your interest in requesting an appearance from the Miss Illinois Scholarship Organization

Please fill out ALL areas of the form. ALL are required for a successful submission. If an area does not apply, type "N/A."

YOU WILL RECEIVE AN EMAIL RECEIPT AND A THANK YOU PROMPT AFTER SUBMISSION IF THE FORM WAS SUCCESSFULLY RECEIVED. IF YOU ARE NOT GETTING AN EMAIL OR THANK YOU PAGE AFTER SUBMISSION, EMAIL missILinfo1@gmail.com TO TROUBLESHOOT THE FORM.

Fees are as follows:

Corporate, Business or All Day* Appearances - $500
School Appearances** - $200-400
Charitable Appearances - $100-150
Local MAO Competitions - $100

* All Day = More than 5 hours
** Depending on number of school presentations

Please Note: If a hotel room can be secured for the night before or night after the appearance (depending on the requested appearance time) then mileage will only need to be paid one way rather than round-trip. Appearance requests with dates beyond May of each year will be addressed AFTER our new state titleholder is selected in June of that year.

Organization*

Event Date*

Date

Event Start Time*

Hour Minutes

AM/PM Option

Event End Time*

Hour Minutes

AM/PM Option

Contact Person*

Organization Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Office Phone Number*

Please enter a valid phone number.

Contact Person Email*

example@example.com

Contact Person Phone Number*

Please enter a valid phone number.

EVENT DETAILS

Description of Organization*

Details of Appearance *

Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contact Person will be on site*

YesNo

Event Contact if Appearance Contact not on site

Expected Audience Size*

What will Miss Illinois be expected to do?*

Perform TalentSpeakTake PhotosSign Autographs

Suggested Wardrobe*

BusinessCasualEvening Gown

Appearance requests are typically reviewed within 3 business days.

I have read the above statements and understand*

Yes