Miss Delta Pageant 2003
Application/Entry Form
Surname of Applicant__________________________________________________
First Name____________________________________________________________
Middle Name___________________________________________________________
Date of Birth_________________________________________________________
Place of Birth________________________________________________________
State of Origin_______________________________________________________
Academic Qualifications_______________________________________________
Are you a Student?____________________________________________________
If Yes, Name of Institution___________________________________________
Programme/Course of Study_____________________________________________
Vital Statistics______________________________________________________
Contact/Correspondence Address________________________________________
______________________________________________________________________
______________________________________________________________________
Telephone Number/Email________________________________________________
Language Spoken_______________________________________________________
Hobbies_______________________________________________________________
Special Talent________________________________________________________
Favourite Meals_______________________________________________________
______________________________________________________________________
Have you contested in any pageant before?_____________________________
If yes,Specify________________________________________________________
CERTIFICATION
I,________________________________________certify that the information
given above is true. I fully understand that if any of the information
above is found to be false, I stand a chance of being disqualified at
any stage of the contest. I accept that the decision of th judges at
the preliminary qualifying stages and the grand finale shall be final
and incontestable. I hereby append my signature as follows with the
provision above.
____________________________________
Name and Signature of Applicant
NOTE
All completed applications/entry forms are to be return to the pageant office at 116/120 Okumagba Avenue Warri Delta State on or before January 7 2003, with the following enclosures.
- 2 Copies of recent Passport size colour photographs.
- 2 Copies of 5 X 7 size Photograph of self.
- A stamped self addressed official envelope.
- Photocopy of relevant academic credentials.
- Photocopy of birth certificate or sworn declaration of age.
- A non-refundable certified bank draft of 2000 Naira or it's
- equivalent in cash made payable to Corporate World Entertainment.
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