Utah Senior America Contestant Application

If you or someone you know would like to be a contestant in the 2010 Ms. Utah Senior America Pageant, please complete the following preliminary application.  This will help to determine if you meet all the participation requirements.  After your application has been reviewed, an official application form will be sent to you.  If you are accepted as a contestant, there is $150 contestant fee which covers the cost of the venue, pageant day expenses and a 1 year membership in the Cameo Club.

First Name:     *

 

Last Name:    *

 

Birthdate:    example: 06/01/1949*

 

Street Address:   *

 

City:      *

 

State:  Utah

 

Zipcode:   *

 

Phone:    example: 801-555-5555*

 

Email Address:      *

 

Primary Talent: 

 

*Required

 

Tell us a little bit about yourself, family, education, occupation, and philosophy of life.

 

All submitted information is kept confidential and is not shared with any third parties.

 

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