Age:_____________________Date of Birth: __________________

Address:________________________________________________

City & State:____________________________________________

Postal Code:____________________________________________

Telephone Number & Area Code:(_______)__________________

I am entering as a ______Pro _______Amateur* *Northern Belle Pageants defines an amateur as a contestant who has not won a supreme or highpoint title in the following categories: divisional supreme, mini-supreme or grand-supreme in the past two year period (August to August)

I am entering the following events:

Supreme Package $295.00_________ (Includes choice of Beauty and any two optionals)

• Beauty/Formal:$200.00_________*Mandatory

• Pro-Am Model:$50.00_________

• Run-Way Model:$50.00_________

• Outfit of Choice: $50.00 ________

• Talent: $50.00 _________*

• Extra Talent:$35.00 _________ (limit 1) (You may add all optional events, the highest scoring optional(s) will be used towards supreme points)

  Separate Event: Photogenics
  Photogenics are not included in the overall scores!

• Photogenic: $50.00 ________

• Extra Photo(s): $15.00 ________

• Optional Overall Titles

• Overall Formal $75.00_______
  
• Overall Pro-Model $75.00_______
  
• Overall Talent $75.00_______ (all three for $175) _______

• Registration Fee $ 100.00 (includes pageant video & Party)

• Sub Total $__________

• Less Discounts! $__________ (Take the highest discount/optionals paid given - $150 maximum combined discounts-unless a supreme package has been won)

  *Entries Received After August 5th, Add $50.00 late fee

• Total Enclosed: $__________($100.00 deposit required)

• Total Due: $__________ (Total Due at Registration in Cash Only!)

*Talent routines are limited to 3 minutes - all performance tapes must be cued

High Points For Grand Supreme, & Novice Supremes are determined by the Highest Combined Scores of Beauty and Two Optional Events. If You Compete in Three or More Optional Events, the Two Highest Event Scores Will be Used to Determine High Points.

Extra Talent -- The Highest Scoring Talent in the event will be credited towards Supreme Points.

Extra Photogenics -- The Highest Scoring Photo will be used to determine the Overall Photogenic and Age Division Winners

Northern Belle Pageants Application - page 2

Rules & Disclaimers:

1. All contestants will be responsible for any accident or injury incurred during a stay at the Pageant or in travel to and from the Pageant, or at the competition itself. The Pageant refers to Northern Belle Pageants and any business, facilities, judges or other officials associated with The Pageant.

2. Judges decisions are final. Please do not approach the judges until after awards! All contestants must show good sportsmanship at all times!

Deadline for Entry before late fees: August 5,2002

Photogenic Entry: Bring Photographs to Registration

Signature of Parent or Guardian:________________________________________________

Print or Type Name:___________________________________________________

Balance payable at the door - cash only.

Checks payable to: Mr. Bruce D. Hemond

There will be a $25.00 charge for returned checks!

Mail to: Northern Belle Pageants, 20 Alfred Street, Chicopee, MA 01020

Telephone Number: 413-593-5303

*Referred by:_________________________________________________________