*If you are submitting your required documents by fax please call or text me first.
If you would like me to email or send you pageant information click here to contact me and request an application package.
Thank you and sorry for any inconvenience this may have caused.
 2012 Miss Ohio US International Pageant 
Entry Form
NAME:________________________________________AGE:_____
ADDRESS:______________________________________________
CITY:_______________________________ZIP:________________
PHONE: (___)__________________CELL:(_____)________________
E-MAIL ADDRESS:________________________________________
DATE OF BIRTH:___________________SWIMSUIT SIZE:_________
DRESS SIZE:_____SHOE SIZE:_____ HEIGHT:__________________
SCHOOL/COLLEGE:________________________________________
OCCUPATION:_____________________________________________
HOBBIES:________________________________________________
TALENTS:________________________________________________
CLUB OR GROUPS:_________________________________________
THREE WORDS THAT DESCRIBE YOU:______________________,
____________________________,__________________________
CAREER GOALS:____________________________________________
RULES/REGULATIONS
I hereby apply as an entrant in the Miss Ohio United States International Pageant, and I agree to and acknowledge as follows:
1. I am at least 18 years of age as of September 30th of the competition year and will be no older than 25 as of October 31 of the competition year. Delegates participating in preliminary pageants
leading to the Miss Ohio United States International Pageant may be 17 years of age provided
that they reach their 18th birthday prior to September 30th.
2. I have not been, nor am I married, nor have I had a marriage annulled. I do not have children nor have I given birth.
3. I am of good moral character.
4. I am a naturally born female and a citizen of the United States.
5. I now reside in Ohio and have done so for at least a period of 6 months.
6. I agree that should I win the title of Miss Ohio United States International, I will participate in
the Miss United States International pageant and will abide by all the rules and regulations
governing that pageant.
7. I hereby release, unconditionally and forever any claim against Mindy Loudermilk, Harrison Productions, LLC, their Directors, companies or respective officers, employees, agents, and assign , which I may have by virtue of my participation in my state pageant or by any use of my name, likeness, voice. I understand my likeness, voice, name & photos may be used in promotional and ad advertising material.
8. I agree to release Mindy Loudermilk, and Harrison Productions, LLC from any and all liability for any injury that may result from participation in publicity, promotion or the pageant. I waive any and all compensation for use of my name, likeness, voice and/or biographical information for purposes of publicity and promotion.
9. If delegate is disqualified or relinquishes, for any reason, any title awarded to her, all prizes must be returned in full and in condition received.
By submitting the entry form and fees to Mindy Loudermilk, delegate agrees to abide by all rules, regulations and policies set forth by Mindy Loudermilk, and Harrison Productions, LLC. Delegate attests that all information is true and accurate. There are NO refunds.
________________________________________________________________________
Contestant/Delegate Date
________________________________________________________________________
Parent Signature if under 21 years of age Date
PAGEANT FEES: $550.00
Final Deadline March 1, 2012
http://missohiousintlpageant.yolasite.com
Mbjproductions@mail.com or mrsmtus2010@live.com
Mindy Loudermilk, State Director, RR 5 Box 538, Salem, WV 26426,
Phone: 304-641-4632 Fax: 304-782-3470
Entry Fee |
|
$ 550 USD |
|
Disclaimer: Your $150.00 deposit and head shot must be received. Please upload your head shot to your application or submit via email: mrsmtus2010@live.com. Head shots may also be mailed to the following address: Mindy Loudermilk, State Director, RR 5 Box 538, Salem, WV 26426
Entry Fee: $550
Please note: Pictures sent by mail will not be returned unless you send a S.A.S.E.
Once your complete application, deposit and head shot is received, the we will review your application and respond to you within 5-7 business days.
For additional questions or concerns email mbjproductions@mail.com.
Application Deadline: March 1, 2012
