MIP Regional Title & International Pageant Application

National Regional Title & International Pageant Application

Please complete ALL the information below to be eligible for the National Regional Title for the International Pageant
* Indicates required field. Form will not go through unless all required fields are filled in. You must be 18 years or older to complete MIP application.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
Age*
Place of Birth*
City, Country
What Region Do You Want to Represent?*
(example: List the name of the Country, Island, State, Region or City & County)
Nationality*
(Please select Nationality)
Home Phone Number*

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Email*
example@example.com
Confirm Email*
example@example.com
Alternate E-mail Address
example@example.com
School/College
Grade In School/College
Occupation*
(if applicable)
T-Shirt Size*
Please select T-Shirt size
Parent or Guardian's Name*
Parent’s Name MUST be complete if you are 8-17 years old
Name of Your Sponsors
How did you hear about Majestic International Pageant?*
Director's Name*
Referred To MIP By
I hereby certify that the information contained in this application is true and correct to the best of my knowledge*

Yes (Note: you must check this box or your application will not go through)
* Indicates Required Field

There will be a fee of $85 for ALL RETURNED CHECKS
Contact Us — E-mail address: info@majesticinternationalpageant.com

ABSOLUTELY NO REFUNDS AFTER FEES HAVE BEEN PAID
I agree to the Rules & Regulations of Majestic International Pageant*

Yes (Note: you must check this box or your application will not go through)
Contestant Signature:*
Parent or Guardian's Signature:
(for contestants under 18)
I will agree to make monthly payments towards my international payment package plan per signed pages 1 and 2 and will return agreement to the international office via email for the agreed dates for payment plan.*

Yes (Note: you must check this box or your application will not go through. An agreement will be sent to you after your application is submitted)
*** $35 Registration/Processing Fee Due Upon Application Submission ***

NOTE: $35 registration/processing fee is required when completing your application. Submit the form after completing your application. You will be directed to the MIP secure payment screen.

All payments submitted from MIP website via PayPal will accrue a 6% processing fee to your total amount to be paid (example $35+$2.10=$37.10).
Pay MIP Registration & Processing Fee
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MIP Registration & Processing Fee$37.10
Please pay the $35 registration fee plus 6% processing fee (total of $37.10) now to guarantee your spot in our upcoming pageant. NOTE: Your application will NOT be submitted until you pay the registration fee. Thank you.

Total $0.00
Date Submitted*

MonthDayYear
DateHourMinutesAM/PM Option

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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National Regional Title & International Pageant Application