Miss CCI/Little Mister CCI 2022 Registration Form

First Name*

Last Name*

Contestant Age as of 1/1/2025*

Address Line 1

Address Line 2

City

State

ZIP Code

Contact Phone Number*

Email*

Parent (s) name if under 18

Contestant Date of Birth (proof of birth may be required at pageant checkin)*

Competition Division:

Junior Miss (9-10 Years Old)Junior Teen (11-13 Years Old)Teen (14-19 Years Old-still in High school)Miss (18+ single, graduated HS, in college/working)-no childrenMs. (18-39 with child/ren, married or single)Mrs. (18+ married)Elegant Ms. (40-59 married/single, with or without children)Classy Ms. (60+ married/single, with or without children)

Do you agree that by completing this application and submitting entry fee, you are committing to attend National competition April 2025? Failure to do so will result in forfeiture of entry fee*

Yes

Do you agree that this is a commitment and you will fulfill your reign as a State titleholder, and if selected, National titleholder of 1 year if crowned as National Queen, which also includes 2 service activities per month?*

Yes

Do you currently hold any other pageant titles?*

Platform/Charitable Cause*

How did you hear about our pageant?

If you are referred by a Current Queen, list their name here:

My Products

Pageant Entry: INCLUDES INTERVIEW, STATE COSTUME REPRESENATION, FORMAL WEAR, OUTFIT OF CHOICE, ONSTAGE QUESTION. PRIZES ARE DIVISION TITLE, SIDE AWARD ENTRIES (NOT OPTIONALS) AND ENTRY INTO DIRECTORS CHOICEENTRY FEE: Includes State appointed title and crown. As well as National Competition Entry Fee (Contestant is responsible for wardrobe, accommodations and travel fee for National Competition) NOTE: Entry Fee includes CC processing fee of $3

$353.00

OPTIONAL: Performing TalentPerform your talent on our National Stage to be selected as Miss National American Most Talented!

$30.00

OPTIONAL: Photogenic CompetitionSubmit one photograph at pageant orientation that will be judged by our judges to be selected for Most National American Miss Photogenic!

$30.00

OPTIONAL: Non Performing TalentDo you sew, bake, craft or have some other amazing talent that isn't performed onstage? Bring a sample of your work to be selected as our Miss National American Non Performing Talent Winner!

$30.00

OPTIONAL: Most Photogenic Pet CompetitionDo you have the cutest pet ever? Bring a photo of your pet to pageant orientation for our judges to review and select the Most Photogenic Pet!

$30.00

Enter coupon

Total

$0.00

Payment Methods

Credit Card

Afterpay

I confirm that I meet the qualifications for your state title & National Competition per our rules & Eligibility Page. https://missnationalamerican.org/application*

Yes

Miss National American Entry Application

Payment Methods