Parent Contact Form

Before completing this form, please register to compete on the Miss America website. Only sign up through registration ($39.99), do not sign up for a local competition!

https://www.club.missamerica.org/miss-america-registration-illinois-page

Please complete the following application to be a delegate for Miss Illinois Teen. The fee to compete At-Large is $500, along with other fundraising requirements. Every delegate must have an official Miss America crown and sash. The crown and sash are at an additional cost to be paid by the delegate. If you have a current MAO Miss Crown you do not need to purchase one. Proof of correct crown will be required.

There will be additional fundraising requirements (i.e. ad pages and raffle tickets to be sold) and that information will be available in the paperwork instructions that you will recieve after payment has been made.

You must attend or have an excused absence for the Spring Kick Off meeting on March 2, 2024 at the Westminster Presbyterian Church 533 South Walnut Street, Springfield, IL 62704

LA Formals in Springfield, IL 2nd floor of the White Oaks Mall will be coordinating the opening number dress sales and fittings. The cost of the dress will be paid by the delegate. LA Formals can be reached at 217-697-7065 and http://www.laformals.com. You may visit them at your convenience to be fitted and select your dress. To guarantee delivery, you must select and order a dress on or before March 2, 2024 (Spring Kick Off). LA Formals will also be offering a discount on additional purchases for Miss Illinois delegates.

Delegate's Name*

Birthdate*

MonthDayYear

Age*

Please let us know what title you would like to have. Many Delegates choose their hometown or area as their title. You may not choose a title that is associated with a local competition already. Keep in mind a delegate cannot be the same title two years in a row regardless if the title was won or chosen as an at-large or appointed title.

Title Request #1*

Title Request #2*

Title Request #3*

Delegate's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Delegate's Home Phone Number*

Area CodePhone Number

Delegate's Cell Phone Number*

Area CodePhone Number

Delegate's E-mail*

Year Delegate Will Graduate High School*

Type of Talent*

ex: dancing, singing, monologue

MAO Teen Crown and Sash*

Crown and Sash ($200)Sash Only (Proof of Correct Crown Required)

I agree to pay the entry fee of $500 along with any selected above charges.*

Yes

I understand there will be additional an additional cost for an opening number outfit that is not included in the entry fee.*

Yes

I understand there will be additional fundraising requirement (i.e. ad pages and raffle tickets)*

Yes

E-mail for Invoice to be sent*

Confirmation Number from MAO Delegate's Registration, if Provided

Teen At-Large Delegate Application