Candidate Application Form

Miss and Teen Candidate Application:

Miss Blackhawk Valley and Miss Blackhawk Valley's Outstanding Teen 2023
Full Name *

First Name Middle Name Last Name
Are you competing for Miss or Teen?

Miss Teen
Local Competition Title
Birth Date

Month Day Year
Date
Age
Candidate E-mail
example@example.com
Candidate's Phone Number *
Candidate's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent(s) Name(s)
Parent(s) Phone Number(s)
Parent(s) Email
School/Student Status
Job
Scholastic Ambition
Career Ambition
Are you claiming eligibility to compete via residence, work, or school?

Residence Work School
Please further explain your eligibility based on your answer to the above question
Talent (type & name of song, if using)
Social Impact Initiative title and detailed information regarding the initiative
What is your goal, what have you done, what do you plan to do, what organizations have you worked with, etc.?
Have you competed in the Miss America Organization before?

Yes No
If yes, when and at what level?
Do you have any relatives who have served as a volunteer, judge, or other official with the Miss America Organization?

Yes No
If yes, please list the relation, position, and last date they were involved with MAO
Have you registered to compete through Miss America, paid your fee(s), and successfully signed up for our local through the Miss America website? This is mandatory in order to compete.

Yes No
Have you created a Spot Fund account? Signing up is required in order to compete.

Yes No
Do you have a fundraising goal and if so, what is it?
Signature

Clear
*Once you submit the application, your eligibility must be reviewed by our Board of Directors to ensure you are able to compete.

Be sure to visit our Miss Blackhawk Valley website to fill out additional required documents.

Registering with MAO, paying your fee(s), and signing up for our local competition via MAO is required.

Please sign up for a SpotFund Account if you have not already done so. Links can be found on our website.
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform

Miss and Teen Candidate Application: