American Grace & Charm Pageant State/Regional Delegate Application

Please fill out all required sections as they will help us select the best representative from each state/region.
Please answer truthfully and read all documentation before signing and submitting.

Applicant Name *
First & Last Name
Your answer
Applicant Date of Birth *
MM
/
DD
/
YYYY
Applicant Age As of April 1st *
We accept delegates ages 4-23, if Applicant is under 18, a parent or legal guardian MUST complete this form and submit.
Your answer
Applicant Gender *
This will only be used to determine the title to be awarded: females will be awarded Miss Grace and males will be awarded Mister Charm.
Applicant Address *
Your answer
Applicant Email *
Your answer
Applicant Phone Number *
Your answer
Best Contact Time *
Your answer
Applicant Certification *
If Applicant is under 18 years of age, Parent must complete and electronically sign this form.
Applicant Parent/Guardian
If under 18 Parent/Guardian must electronically sign
Your answer
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