Title Relinquishment Form

Title Relinquishment Form

Please fill out this form to formally relinquish your current title so you can compete for a new title.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number
Please enter a valid phone number.
Title Being Relinquished
Date of Relinquishment*

MonthDayYear
Date
Reason for Relinquishment
I understand and acknowledge that I am willingly relinquishing my current title so that I may compete for a new title in the Miss America/Miss Illinois system. I also understand that I can not hold the same title for 2 consecutive years. If I am competing at the same local where my current title was awarded, I would only be eligible to be selected for a different title if more than 1 title is being awarded.
Signature (must be 18 or over)*

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Signature Name (if you are under 18, you must have a parent/guardian sign)
Verification*
Should be Empty: