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MEET THE JUDGES
  Tuesday, September 07 2010  
Application Form

Want to be the next Miss Africa USA?  Fill out this form so you can become a contestant in the running to represent your country in the next Miss Africa USA Pageant

First Name: Last Name:
Address 1: Address 2:
City:
State:
Postal Code:
Phone: Email Address:
Your Height: Your Date Of Birth:
Your Weight:    
African Country You Want To Represent:



Where did you find out about the Miss Africa USA Pageant?

Email/Newspaper advertisement    
Flyer or poster    
Friend or family    
Personal inquiry    
Myspace/Facebook advertisement    
Miss Africa USA website Reference #1 Name:
Contact from Carmen G Reference #1 Phone:
Contact from AfroHeartBeat    
Contact from Harold/H Greaves Photography Reference #2 Name:
Other
Reference #2 Phone:



Brief Description of Yourself

Your Photo #1
 
Your Photo #2
Your Photo #3



  Guest Book
  Name:
  Email:
  Location:
  Comments:
     
 
 


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