CASTING

APPLICATION FORM FOR THE

2017 /2018 MISS MUNDO LATINA USA PAGEANT

(ORLANDO, FLORIDA)

 

Full Name (required)

Age

Address (required)

City (required)

State

Zip Code (required)

Email (required)

Cell Phone (required)

Category

Best phone number to reach you at?

Best time to call you:

I was born in the United States:

I am a legal resident of the United States:

Languages
SpanishEnglishBoth

Mother’s Name

Father’s Name

Parents Place of Birth

What Country, State or City do you want to represent?

Date of Birth (required)
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What will your age be on August 6, 2016?

Have you ever been married?

Have you given birth to any children?

MARITAL STATUS: Select one:

How do I find you on Facebook? Please list your Facebook Url:

Photo 1

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I have read & agree to the general RULES & REGULATIONS of the Miss Mundo Latina US Pageant:

I understand & agree that the 2017 Miss Mundo Latina US Pageant will take place in August 3-6, 2016 and will attend, otherwise forfeit my registration fee with no refund.

I understand and agree that any and all fees paid to the Miss Mundo Latina US are non-refundable and non-transferable in full or part under any circumstances.

I have filled out my own application form:

I do hereby swear that the statements made on this application form are true.

I am aware that if any statement made on this application form is willfully false, I am subject to disqualification and/or forfeiture of prizes won without benefit of refund in full or in part at the sole discretion of the Miss Mundo Latina US Organization.

I understand and agree that this electronically reproduced signature is considered valid as the original.

Signature:

Date:
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