Mrs. New York America 2018

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Please fill out the form for the 2018 Pageant. We will contact you soon.

DATE *

YYYY

FULL NAME *

HOME ADDRESS – CITY-STATE-ZIP CODE *

HOME PHONE *

MOBILE

AGE *

DATE OF BIRTH *

YYYY

BIRTHPLACE *

U.S. CITIZEN *

Yes

HEIGHT *

WEIGHT *

EYE COLOR *

HAIR COLOR *

BUST-WAIST-HIPS *

SHOE *

DRESS *

SWIMSUIT SZ *

MARRIAGE (Month/Day/Year) *

YYYY

OCCUPATION & ADDRESS OF EMPLOYER *

HUSBANDS NAME *

CHILDREN’S NAMES & DATE(S) OF BIRTH *

NAME & LOCATION OF SECONDARY SCHOOL *

NAME & LOCATION OF COLLEGE, UNIVERSITY OR OTHER *

LEVEL REACHED & DEGREE(S) *

DESCRIBE CURRENT & RECENT COMMUNITY INVOLVEMENT *

HOBBIES, TALENTS & GENERAL BACKGROUND *

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