2024 National Imperial Miss | State Application| Southwest Regional State

Delegate's Name*

Age*

AS OF JUNE 1, 2023

Division*

Jr. Princess ( Age 4-6)Princess (Age 7-9)Pre. Teen (Age 10-12)Jr. Teen (Age 13-15)Teen (Age 16-19)Miss (Age 20-29 *Never married and never given birth)Ms./Mrs. (Age 20+ *May have children and can be married, divorced, and/or widowed.)Legacy (Age 50+ *Regardless of marital status)

State*

WHAT STATE DO YOU LIVE IN?

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

STREET ADDRESS, CITY, STATE AND ZIP CODE

Referred by

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

Please upload a professional headshot*

You will have the opportunity to submit another photo for the program book.

I understand and agree to the Official Rules and Regulations for the National Imperial Miss Pageant and National Imperial Miss, LLC.. Delegates and parents/guardians of minor delegates must read and adhere to the rules and regulations, to be eligible to complete, found on the National Imperial Miss website. I have read and agree to all the program rules found on the National Imperial Miss website. I have read and agree to the responsibilities and requirements that I will have as a state titleholder for National Imperial Miss, as the Titleholder Agreement can be found on the National Imperial Miss website, including the requirement to compete at the national pageant. By submitting this application, I certify that I am a natural born female and will compete as such, that I am a legal resident and citizen of the United States of good moral character. I agree that National Imperial Miss has the right to refuse this application at its sole discretion and a refund of the entry fee will be provided if this application is refused. I also understand and that all fees are non-refundable and non-transferrable.*

Clear

State Entry*

State Entry State Pageant Entry Includes a Entry fee $175, $50 Scholarship fund, $50 Ad page fee and a $25.00 online processing fee.

$300.00

Secondary Title OptionWe will crown 2 state winners per division to advance to our award winning national pageant, winners will receive their national entry fee paid!

$100.00

Cover Miss Optional (1 Photo)Put your best face forward! Our photogenic competition can win you the state Cover Miss award and qualify you for our Imperial Supermodel competition. Photos submitted may be either color or b&w and must be 8x10. Please have photos in sheet or photo protectors and have your name and division on back of each photo submitted. More than one entry is allowed, submission is during registration. One winner per age division.Fee: $50 1 photo, $75 Unlimited , Max 4.) Photos must be age appropriate, follow makeup guidelines by National Imperial Miss, and must be professional quality.

$50.00

Cover Miss Optional (Unlimited Photos 4 max)Put your best face forward! Our photogenic competition can win you the state Cover Miss award and qualify you for our Imperial Supermodel competition. Photos submitted may be either color or b&w and must be 8x10. Please have photos in sheet or photo protectors and have your name and division on back of each photo submitted. More than one entry is allowed, submission is during registration. One winner per age division.Fee: $50 1 photo, $75 Unlimited , Max 4.) Photos must be age appropriate, follow makeup guidelines by National Imperial Miss, and must be professional quality.

$75.00

Imperial SuperModelThis modeling competition is based on your fun-fashion score during the required competitions and your Cover Miss photo entries. One winner per division. Fee: $50

$50.00

Total

$0.00

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