Kimberly Rosa ....... 246 Kaliponi St. ....... Washiawa,  HI  96786  .....  808-621-9032

HOME

- ONLINE APPLICATION -

STEP 1:  General Information

Title I am applying for:

Teen    Miss     Ms        Mrs.      Ms Elegant     Classic Ms

Name:

Age:

Birthdate:

Street Address:

City:

State:

Zip Code:

Country:

Telephone:

Email (valid email required):

STEP 2:  Tell us about yourself:

Workplace:
Position:
Hair Color:
Eye Color:
Height:
t-Shirt Size:
Hobbies & Interests:
Other Pageants Entered:
Past/Current Titles Won:

Tell us something about yourself:

By submitting this form I confirm that I have read, understood and agree to abide by the rules and regulations set forth by Connie Lynn Productions in the Worldwide pageant competition.  If I am under 18, I have obtained my parent permission to participate in the pageant and to use their credit card.

If all of the information is correct...   press the submit button to continue.

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