Miss America Candidate & Parents Contact Form

A receipt acknowledgement along with a copy of submitted info will forward to your email address.

Guidelines for Completing the Candidate & Parent Contact Form

Navigating the form — Use the Tab key or your mouse to move between fields. Required fields will prompt you automatically if left blank.
What to include — Provide complete mailing addresses, email addresses, and phone numbers for all contacts. Also, include a shipping address for any items that may need to be sent to the candidate before the National Finals.
If information changes — Contact your State Executive Director right away with any updates to contact information, or if you have questions. Your State ED will relay that information to Miss America Headquarters.
Confirmation — Once submitted, a confirmation will be sent to the email addresses provided for both the Candidate and the State Executive Director.

Miss America National Candidate Information

Complete all required areas below.

Enter N/A for any questions that do not apply.

State *

Select Program *

Miss

Teen

Select Title *

Candidate's Full Legal Name

First Name *

Middle Name

Last Name *

Date of birth *

Current Age *

Candidate's Hometown *

Hometown State *

Candidate's Latest Local Title *

Talent *

Community Service Initiative *

Languages *

Enter N/A for Not Applicable or list: Spanish, Mandarin Chinese, German, etc

Residence Street Address *

City *

State *

ZIP *

Candidate's Home Phone *

Candidate's Cell *

Candidate's Email *

College/University *

Graduated *

Degree *

College Major *

College Minor

Graduate School *

Shipping Information - If different from your Residence address above.

Shipping Name *

Shipping Address

Shipping City

Shipping State

Shipping ZIP

Shipping Phone

CANDIDATE PASSPORT INFORMATION

Since Miss America may travel internationally, it is important she has a current passport. Please respond to the questions below on the status of your passport:

I have a current passport

Yes

We strongly encourage each candidate to obtain a passport prior to nationals.

PARENT/LEGAL GUARDIAN INFORMATION

MOTHER'S INFORMATION:

Mother's Full Name *

Street Address *

City *

State *

Zip *

Home Phone *

Cell Phone *

Mother's E-mail *

FATHER'S INFORMATION:

Father's Full Name *

Street Address *

City *

State *

Zip *

Cell Phone *

Home Phone *

Father's E-mail *

LEGAL GUARDIAN'S INFORMATION:

Legal Guardian's Full Name

Street Address

City

State

Zip

Cell Phone

Home Phone

Guardian's E-mail

UPLOAD Delegate's Official State Competition Headshot *

Click to upload

PNG, JPEG or JPG

SUBMITTED BY:

State Executive Director *

State ED Email *

State ED Cell Phone *

Enter Name, if submitted by other than State ED

Enter State Title, if submitted by other than State ED

E-mail Address, if submitted by other than State ED

Cell Phone, if submitted by other than State ED

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.