Teen Miss & Miss Lumbee Pageant Application 2023
GENERAL INFORMATION
Name
*
First Name
Middle Name
Last Name
Category
*
Teen Miss
Miss Lumbee
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Address
*
Street Address
Mailing Address (if different than above)
City
State / Province
Postal / Zip Code
Email
*
You will receive most communications though email. Please make sure this is an email you check regularly.
Mobile Phone Number
*
-
Area Code
Phone Number
Parent's Mobile Number( if under 18 years old)
-
Area Code
Phone Number
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ADDITIONAL INFORMATION
If a question doesn't apply to you please type N/A
List Hobbies/Interests
*
List Awards/Accomplishments
*
List Community Service /Volunteer Experience
*
Platform Statement
*
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Education/Future Plans
If a question doesn't apply to you please type N/A.
Check All That Apply
*
High School Student
High School Graduate
College Student
College Graduate
If you are currently a high school or college student, what year or grade are you in?
*
What is the name of your school or university?
*
If you are currently attending college or are a college graduate, what is/was your major?
*
If you have graduated from high school and/or college, what year did you graduate? List school and year of completion. ( ex. Purnell Swett High 2021, or UNCP 2021)
*
Future Plans
*
Cultural Experience
*
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Talent Information
Talent
*
Dancer
Singer
Monologue
Song /Music Title
*
If you are not sure yet, list it as undecided. If you are not using music mark it as N/A. Please note in the event that two people select the same song the first one received will be accepted. Contestants CAN NOT use the same song.
Give a detailed description of your talent.
*
This will be used in the pageant script for your talent introduction.
Type of equipment you will need: NO PROPS ALLOWED
*
Handheld Microphone
Microphone with stand
Piano
Piano with Accompaniment
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Required Documents
Please upload the following documents. 1. Three Professional References 2. Proof of Tribal Enrollment 3. One Page Essay 4. Birth Certificate
Upload 3 Professional References
*
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Proof of Tribal Enrollment
*
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Picture of Tribal Enrollment Card or Certification Letter. You may use the parent's card if the applicant does not have an enrollment card but a biological parent does.
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One Page Essay
*
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The essay should be Times New Roman typed double-spaced with 12pt. font. Please include your name at the bottom of the page. Word or PDF file format only. No pictures, please.
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Birth Certificate
*
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Contestant Agreement
As a potential Teen and Miss Lumbee Scholarship Pageant contestant, I agree to abide by the rules and guidelines listed in this application. I also confirm that I meet all the qualifying criteria LRDA and the pageant committee have set forth. I understand that all rules will be strictly enforced and that any violation of the rules and guidelines could result in my disqualification as a contestant. To the best of my knowledge, I attest that the information provided in this application is true and accurate. (If under 18, parent's signature is required)
Applicant Signature
*
Clear
Parent Signature (If under 18 years old)
Clear
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Application Fee
Please choose your method of payment. You can pay now or choose to mail or drop off your payment to LRDA by the application deadline. PLEASE NOTE: Applications are not considered valid until payment is received. CHECKS DROPPED OFF AT LRDA MUST BE IN A SEALED ENVELOPE ADDRESSED TO THE ATTENTION OF NATASCHA TILSON, PAGEANT DIRECTOR WRITTEN ON THE FRONT. MAILED CHECKS SHOULD BE MAILED TO LRDA ATTENTION: NATASCHA TILSON P.O. BOX 68 PEMBROKE, NC 28372 If you choose to mail your payment just click submit without entering a dollar amount and your application will be submitted.
Application Fee
Payment Options
Pay Now
Mail Check
Drop Off Payment
Pass To Payment
Application Fee
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Payment Methods
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Last Name
Credit Card Number
Security Code
Card Expiration
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