America's Junior Miss competition application

Would you like to participate in the America's Junior Miss scholarship program? Complete the form below and press the 'Submit Application' button. Items in red are required.

Contact Information
If you cannot complete a required field, please contact us for assistance.
First Name
Middle Name
Last Name
Street 1
Street 2
Street 3
City
State
Zip Code
County, Parish or Borough
Phone (Home)
Phone (Cell)
E-mail Address
Confirm E-mail

Requirements
In addition to the following requirements, contestants must compete in all of these categories: Interview (25% weight), Talent (25%), Scholastics (20%), Fitness (15%) and Self-Expression (15%).
U.S. Citizen?	yes no
Ever Married?	yes no
Ever Pregnant?	yes no

Graduation
Don't make this common mistake: If your senior year begins in 2010, for example, then you will likely graduate in the Spring of 2011. Also, for some states, competition begins as early as your Junior year, so apply early!
When will you Graduate from High School?