Language
English (US)
OPEN HOUSE Seminar Reservation Form
HELLO! We are super excited to meet you. Please reserve your seat for the Open House Miss Juneteenth Informational and Registration seminar by completing the form below, specify the expected number joining the conference.
Please select the Virtual. Open House that you are attending.
Friday, NOV 10th @ 7 PM
Candidate Information
Candidate Full Name
*
First Name
Last Name
What high school do you attend?
How Old are you?
When is your Birthday?
-
Month
-
Day
Year
Date
E-mail
*
example@example.com
Number of people attending *Must be accompanied by Parent or Guardian.
*
What is your Talent?
Gymnast, Dance, Music, Theatre, Sing, etc
How did you hear about the Miss Juneteenth Virginia Open Call Seminar?
Social Media
Parent/Friend
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My Email
Parent Information
Parent or Guardian's Full Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Submit
Should be Empty: