City Directorship Inquiry Form

City Directorship Registration

Complete your Local City Directorship request by filling out the form below. The Directorship covers from July 2024 - June 30th 2025. Orientation will be held the last week of August 2024 to kick off Cycle 3!! We can't wait to meet you. #IMPACTVA
Enter your city that will be represented in the State Pageant.*
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you registering your City under yourself or under an organization? Ex. NAACP of Franklin*

IndivdiualOrganzation/Group
Do you have an established Juneteenth Pageant in the city that you are representing?*

YesNo
How many years has your pageant or organization been active?*

0 - Just Starting Out1 Year2-4 Years5+ Years
Why do you want to take the lead for your City?**
Briefly describe your experience in Youth activities, mentorship, and/or management.*
What is your current occupation and do you forsee any conflict with the amount of time required for a successful local pageant/crowning?*
How many members are on your team/staff/ organization or committee?*

1-56-10Over 10
Please provide a brief summary of what you consider to be relevant Juneteenth History, Black History, and other historic areas in your City?*
What is your Social Media Page for your Group or Organization?
If registering as an individual, please enter NONE
What Official Name or Organization do you wish to be listed as on the Official State website directory?
Do you currently have a Logo for your organization?

YesNo
Please upload your LOGO for the Official State Directory, if applicable.

Cancelof
We want to know you! 😊Please tell us about yourself by uploading YOUR BIO or a short resume. (*Can be sent separtely via email)

Cancelof
STATEMENT OF UNDERSTANDING:

As a registered City Director, you fully understand that all pageants/crownings are at your discretion and that all guidelines that are outlined in the forthcoming Local Directorship Guide must be adhered to to remain an active participant in the Miss Juneteenth USA pipeline. All local directors must make a considerable effort to attend the bi-monthly meetings to ensure a smooth Cycle year and that you will be actively engaged in support of the Miss Juneteenth Virginia initiatives and events. You further understand that all Pageants, Crownings, or Appointments must be COMPLETED by March 1, 2025 to participate in the 2025 Miss Juneteenth Virginia Statewide Pageant and that you further understand that your that should you drop from the City Directorship pipeline, all fees transfer over to a donation towards the Scholarship Fund. No Payment is required to apply.
If selected, what payment schedule would best suit your needs?

Payment in fullSplit Pay Option 1 ($200 + $200)Split Pay Option 2 ($100 x3 Payments of $100)
Payments are processed through Square Inoices/CashApp. You may pay using any major credit card / debit card to complete your payment. All Directorship fees are NON REFUNDABLE.
Please verify that you are human*
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City Directorship Registration