Miss Hollywood's Outstanding Teen
PRELIMINARY ENTRY FORM

The 2012 competition will be Saturday and Sunday, January 28 and 29, 2012. We will send complete entry materials to everyone who has submitted this completed form.
By submitting this entry form, you are indicating
that you have read and understand the
IMPORTANT NOTICE below.

Entrant's Name

Date of Birth (month/date/year, e.g., 02/28/95)   /     /  

Year In School

Street Address

City, County

Zip Code

Daytime Phone Cell Phone (if different)

E-mail Address

Talent Description: In the space below, please describe the talent that you will perform in the talent competition.

Have you competed previously in a Miss America's Outstanding Teen preliminary or state pageant?        
Yes        No

Have you competed in a pageant not affiliated with Miss America?        
Yes        No

Are you a citizen of the United States?        
Yes        No

How did you hear about us?

   IMPORTANT NOTICE
   A contestant's performance in the talent competition
   is limited to 2 MINUTES.

   NOTE: THERE IS A $100 NON-REFUNDABLE ENTRY FEE
   PAYABLE UPON SUBMISSION OF ENTRY PAPERWORK.

Final date for acceptance of on-line Preliminary Entry Forms for the 2011 competition is December 31, 2011. Even if you are entering another pageant, and may not be able to compete in Miss Hollywood's Outstanding Teen, you should submit a Preliminary Entry Form and other required paperwork by our deadlines to reserve your space in our pageant. Final entry deadline is January 5, 2012. No late entries accepted.