Ms. Plus International 2000 Kimberlee Ratliff

Name:_____________________________
Age:______ Birth Date:__/__/__
Address:_____________________________________________
____________________________________________________
City:_____________ State:___ Zip:____________________
Telephone # and/or E-mail address:_________________________
(Please include country code if outside USA)
Occupation/School:_____________________________________
Marital Status:__________________
Sponsors (if any):__________________________
State/Country Title Applying For:___________________________
2nd Choice for State title:_________________________________
I am officially applying for a state/country title in the Ms. Plus International Pageant System. I fully understand that by signing this document, I give the Ms. Plus International pageant permission to use my name and likeness for promotional purposes.
Signature________________________ Date:_____________