DOMINICA’S National Carnival Queen Pageant

Dominica's National Carnival Queen Pageant

CONTESTANT APPLICATION FORM
Contestant's Name*
Contestant's Email Address*
example@example.com
Contestant's Phone Number*
Please enter a valid phone number.
Contestant's Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Village

CityCurrent Parish
Parish of Orgin*
Which part of Dominica did you Orginally live in
Date of Birth*

MonthDayYear
Date
Place of Birth*
Location of Birth
Name of Parents/Guardians*
Portrait Photo*

Photo must show your face visible without anything covering it. No Filter photos
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Are you single and childless?*

YesNo
Have you been convicted of a criminal offence?*

YesNo
Are you Employed*

YesNo
If Yes, Name of Employer
Employer's Email Address
example@example.com
Last School Attended (Secondary/College/University)*
What Language(s) do you speak?*
Have you participated in any other beauty pageant?*

YesNo
If yes, what is the name and when and where did it occur?
Did you obtain any title?*

YesNo
If yes, what is the name of the title?
What is your Life Ambitions*
What are your hobbies*
Do you have any talents? (Describe)*
Measurement
Height*
Bust*
Waist*
Hips*
Weight*
Hair Color*
Eye Color*
Shoe Size*
Dress Size*
Why do you want to particpate in this pageant*
The following must be submitted:
- Passport Size photo
- Valid Police record
- A portfolio to include pictures
- A biography of yourself
- Academic achievements and Qualification
- Police Record
(Please provide certified copies of all certificates)

Police Records and Certified certificates can be submitted at a later date.
The Following must be submitted:*

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Provide at least one Reference *
Reference Contact*
Please enter a valid phone number.
Should be Empty:

Dominica's National Carnival Queen Pageant

Measurement