America's Ultimate Queen

Online Entry Form

Division: Teen  Miss    Woman              Mrs. Classic

Title choices: 1st

2nd

Age:     D.O.B.:

Name:

Address:

Phone: (           )                          Email:

Height: Hair:       Eyes:

If employed, occupation:

If student or unemployed, ambition:

Entry fee$200

Registration Fee (mandatory of all delegates) $100  

Optional swimsuit$30    

Extra photogenics$15/ea.#    

Admission tickets$10# 

Total    

minus any discounts

minus deposit    

Balance    

Make all checks payable to Sara Hayes.

Online entry form will be sent to national office.

Paypal payments may be made to americasultqueen@aol.com

$100 deposit is required to reserve your title.