Miss Black Ohio Pageant Application

Applicants Personal Information:

(Please print clearly)

Name: ___________________ _________ __________________

First Middle Last

Address:_____________________________________________________

City_________________________________________Zip__________________

Age as of: 01/01/2018: _______ Date of Birth: __/___/______

Home Phone: _____________________ Work Phone: __________________

Cell Phone: _______________________

Email Address: _________________________ @__________________. Com

(Email address is mandatory and can be obtained free at yahoo, hotmail, or other providers)

Categories:

Miss Black Ohio Teen Ages 15-18

Miss Black Ohio Ages 18-28

Requirements: Resident of Ohio at least 6 months/Natural Born Female/ African American/ Minority/Other

Competition:

Talent, Swim wear, Evening, Projection questions, Opening dance production, workshop participation, community involvement

Entry fee of $100.00 and $50 is due upon registration.

Free pageant etiquette workshops & 1 MBO T-Shirt

Deadline registration June 30, 2018

Return to: P O BOX 83107, Columbus, OH 43203