Ms. Colorado Senior America Pageant, Inc.

Contestant Application 2017

Sunday, April 23, 20176 - 2:00 p.m.

Lakewood Cultural Center

470 S. Allison Parkway, Lakewood, CO 80226

NAME: (First) ______(Last) ______

(Please use legal name as shown on driver's license)

NICKNAME: ______

(or name you wish to be known as during the pageant. Note: if this is a stage name, please provide your Actors Guild or other documentation).

ADDRESS: ______

CITY: ______STATE: Colorado ZIP: ______

PHONE: ______CELL PHONE: ______

EMAIL ADDRESS: ______

DATE OF BIRTH: ______

MARITAL STATUS: Married ______Single/Divorced______Widowed ______

Husband’s Name: ______

NUMBER OF: Children: ______Grandchildren:______Great Grandchildren: ______

ARE YOU PRESENTLY EMPLOYED: Yes ______No ______

WHERE: ______

HOW DID YOU HEAR ABOUT THE PAGEANT?

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REQUIREMENT FOR PARTICIPATION IN PAGEANT:

1. Contestant must be 60 years of age or older by the date of the Pageant.

2. A $185 entry fee must be submitted by no later than February 15, 2017. The Contestant Application and Agreement must be completed, signed and submitted on or before March1, 2017.

3. If your application is not accepted by the 2017 Ms. Colorado Senior America Pageant (MCSAP), the entry fee will be fully refunded. The MCSAP reserves the right to deny an application and refund the entry fee at their discretion at any time prior to the beginning of the Pageant and remove the Applicant from participation in the Pageant.

(The following information gives the Pageant Committee and Judges a little insight about you.)

ORGANIZATIONS: (Please list names of organizations you currently or have belonged to that show your community service or experience).

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VOLUNTEER WORK: (Please list names of organizations you currently or have belonged to that show your community service or commitment to others.)

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SPECIAL INTERESTS:(Please list your special interests or hobbies.)

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AWARDS:(Please list service awards, employment awards, etc.)

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BACKGROUND/WORK EXPERIENCE (briefly):

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BIOGRAPHY

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WHAT HAS IT BEEN LIKE SINCE YOU REACHED AGE 60?

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PAGEANT PRESENTATION INFORMATION

INTRODUCTION forPhilosophy of Life. Write a very brief bio of yourself (interests, hobbies, family) – do not exceed 3 lines. (This information will be placed in the stage script and read by the MC as you go onstage to recite your Philosophy of Life).

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“From ______,Colorado, Please welcome Ms.______.”

PHILOSOPHY OF LIFE: Must be recited in 35 seconds or less

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“From ______,Colorado, Please welcome Ms.______.”

INTRODUCTION for Evening Gown. Write a brief bio of yourself (interests, hobbies, family) – do not exceed 3 lines. (This information will be placed in the stage script and read by the MC prior to your entrance on stage in your evening gown).

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MODELING EVENING GOWN - In 70 words or less, write some interesting facts about yourself. Be creative, share beliefs, brief background, family, etc. (This information will be placed in the stage script and read by the MC as you walk across the stage in your evening gown).

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“From ______,Colorado, Please welcome Ms.______.”

TALENTPRESENTATION

A 2 minutes 45 second time limit is placed on your talent. You need not use all of the allotted time; however, you cannot exceed the time limit or points will be deducted.

Brief description of Talent presentation: ______

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Composer/publisher, if any: ______

INTRODUCTION for Talent Performance - do not exceed 3 lines. (This information will be placed in the stage script and read by the MC prior to your entrance on stage for your talent.)

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“From ______,Colorado, Please welcome Ms.______.”

PHOTOGRAPHS

A good quality 4x6” head and shoulders picture in .pdf format must be submitted by email to , or on CD. This photograph will be shown in the Pageant Program Booklet and will be provided to the Judges. If available, a photographer may come to a rehearsal (date TBD) to take head shots of those contestants who may require it.

ACCOMPANIMENT/PRESENTATION REQUIREMENTS:

CD (______) (______) NONE

(______) LIVE ACCOMPANIST – if so,what instrument? ______

CD must be clear and of good quality with only the music needed for your performance on it. Two CD’s should be provided – one for the sound system operator and one for a backup.

SELECTION OF MUSIC: No duplication of music performed. Please note that priority is given to the Contestant who submits her music for talent first when submitting her Application/Agreement.

MICROPHONE PREFERENCE:

(______) HAND HELD (______) STAND (______) HEAD SET

PROPS (Provided by contestant) ______

DISPLAYS REQUESTED? (i.e. table, chair) ______

Note: Our onstage crew will be available to assist you with your presentation needs during the rehearsal.

CONTESTANT WRITE-UP

In 70 words or less, write what you want to be printed in the Pageant Program Booklet next to your photo. Anything over 70 words will be revised at our discretion.

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