Registration

(please type or print clearly)

Miss India New York    Miss India USA    Miss India Worldwide Year:

Name: _____________________________

Residency Status: Citizen Permanent Resident Other (specify)

Address: _______________________________________________________________

Telephone: Day: ______________________ Evening: ___________________________

                 Mobile: ______________________  Fax:   ___________________________

 E-Mail: ______________________  Website (if any) : ______________________

Age: _____  Date of Birth (MM/DD/YY)_____________ Birthplace:________________

Height: ___’___” Weight: (lbs.)_______ Languages spoken: ______________________

Do you need an interpreter? Yes No

Father’s Name: _______________________ Mother’s Name: _____________________

Guardian’s Name: (if different from parents)___________________________________

Guardian’s Address:_______________________________________________________

Your occupation:________________________ Education: ________________________

Hobbies and Interests: (if more space is needed, please attach paper) ________________________________________________________________________

________________________________________________________________________

Goals: __________________________________________________________________

____________________________________________________________________

Talent Information:

YOU WILL BE ALLOWED A MAXIMUM OF THREE MINUTES TO PERFORM YOUR TALENT.  THERE ARE ABSOLUTELY NO EXCEPTIONS TO THIS RULE. Describe the talent you will be performing. 

Please be specific:

__________________________________________________________________________

__________________________________________________________________________

Special Requirements:

Microphone Microphone and Podium Other (please describe) ________________________________________________________________________

I will be performing my talent to recorded music. (Please bring two copies of the professionally recorded music with your name clearly written on them.  These cassettes will become the property of IFC. MAKE SURE YOUR MUSIC IS NO LONGER THAN THREE MINUTES)

___________________________________________________________________

Passport Information:

Country:___________________________ Passport No.___________________________

Place of Issue: ______________________ Dates of Issue and Expiration:_____________

Health Information:

Vegetarian Non-Vegetarian

List any allergies we should be aware of: ______________________________________

Please list any and all handicaps that apply to you: _______________________________

Your physician’s name: ________________________ Tel:________________________

Name of Health Insurance:______________________ Policy #:____________________

References:

1.Name_____________________Relationship:__________________

Tel:_________________E-Mail:_________________

2.Name_____________________Relationship:__________________

Tel:_________________E-Mail:_________________

Any information that was not captured in the application may be stated here: (Please use additional paper if necessary)

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

I have read and agree to follow the Rules and Regulations for the pageant I wish to enter.  I also certify that the information presented in this form is correct.  I also understand that the IFC reserves all rights pertaining to this contest and its decision is final.

Contestant’s signature:_____________________________ Date:___________________

Click here to download the form in Microsoft Word format

All About The Miss India New York Pageant

Rules And Regulations

Registration

Glimpses From The Miss India New York Pageant '00

Glimpses From The Miss India New York Pageant '01

Miss India New York 2002 Pageant - (Coming Soon)

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