Ms. Cont'l America Personal History Form

Name:____________________________________________________ Age:________________

Address:______________________________________Apt. No.__________ Zip:___________

City:__________________________ County:_____________________ State:______________

Date of Birth: ___________________ SS#_________________ Telephone (H) ______________

Height:______ Weight:______ Bust:______ Waist:______ Hips:______ T-Shirt Size __________

Dress Size:________ Shoe Size:________ Hair Color:_______________ Eye Color:___________

School:___________________________________________Year/Grade in School:__________

E-Mail:______________________________________________________________

Hobbies:_______________________________________________________________________

Talent:_________________________________________________________________________

Other Education:_________________________________________________________________

Clubs and Groups you belong to in school:_____________________________________________

______________________________________________________________________________

Three Words that describe you:_____________________________________________________

Honors and Awards:______________________________________________________________

Favorite Foods:__________________________________________________________________

Career Goals:____________________________________________________________________

Mother's Name:___________________________________ Occupation:____________________

Address:_________________________________________ Work Phone:____________________

Father's Name:____________________________________ Occupation:____________________

Address:_________________________________________ Work Phone:____________________

How did you hear about the pageant?_________________________________________________

Please print this form and fill out completely.  Sign and return with your nonrefundable
application fee and a recent photo or snapshot.  Make all checks payable to and return to: