Complete This Form Along with Other Required Paperwork

2018 MISS TEXAS LOCAL PAGEANT

CMN FUND FORM

COMPLETE THIS FORM ALONG WITH OTHER REQUIRED PAPERWORK

·  Complete this form prior to entering each local pageant.

·  Use the Tab key to move from one required field to the next.

·  The information will be used by the Local Pageant Executive Director(s) to complete information required by the Miss America Organization

·  Submit completed form in one email to the Local Pageant Executive Director(s)

LOCAL PAGEANT INFORMATION
Title: / Date:
CONTESTANT’S INFORMATION
Name:
Age (as of December 31, 2018):
I am enrolled at: / Classification:
Address:
City: / State: TX / Zip:
Cell Phone: -- / Other Phone: --
Email address:
CHILDREN’S MIRACLE NETWORK INFORMATION
(specific to this pageant)
How much time have you dedicated to raising CMN funds for this pageant? HoursSelect OneMinutesDays
What is the total amount of CMN funds you have raised for this pageant?
OTHER COMMUNITY SERVICE PROJECT INFORMATION
(specific to this pageant)
Project Name / Project Hours / Amount Raised