Application Form

Miss Yakima County Program Application

Deadline to enter September 15, 2023 and paperwork deadline September 23, 2023
Contestant Name

First NameMiddle NameLast Name
I am applying for:
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contestant E-mail
example@example.com
Parent's E-mail (if under 18)
example@example.com
Mobile Number
Format: (000) 000-0000.
Parent's Phone (if under 18)
Format: (000) 000-0000.
Talent Presentation including needed props
Community Service Initiative
Attach Headshot

Cancelof
Additional Comments
Signature

Clear
Should be Empty:

Miss Yakima County Program Application