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Pageant Date: Please select one.
 
Name:
Age:
Spell name phonetically (for M/C) 
 
Birthdate:
Hair Color:
Favorite Color:
 
Eye Color:
Favorite Food:
Siblings:
Favorite TV Show/Movie:
Pets:
Hobbies:
Ambition: Best Friend:
Sponsors:
Parents:
Mailing Address: 
City: State:
Zip:
Home Phone: Work Phone:
Email:

Talent/Commercial: 3.0 minute time limit. All tapes/CD’s must be cued! Be sure to bring a back-up tape for each music.

Music 1: Music 2:
Microphone (If applicable) 
  Hand Held:               Standing:     
Copy/Birth Certificate ~ Please Mark Appropriate Box:  
Enclosed with entry:    Will present at registration:      On file with Intl office

Consent to participate:I agree to hold harmless the Directors, staff and location of the Universal International pageant. Contestants, parents, and guests must abide by all rules and regulations set forth by Universal International. Good sportsmanship is a must at all times. We reserve the right to accept or reject any applicant. I realize that any infraction of the rules may result in disqualification. There are no refunds. I hereby grant Universal Miss the right to use any photograph. Videos or movies made during the competition or any other Universal International activity and allow them to use my name with any before mentioned, in any promotional efforts made in behalf of Universal International in this or any subsequent year. We reserve the right to divide, combine or cancel any division. You must provide your social security number for any cash prizes to be awarded. The judge’s decisions are final.

Signature of Parent or Guardian:
Date:


FEES
(Please note - this form does not calculate fees. Simply complete the form by entering the correct value in each of the boxes.)

All contestants MUST Pre Register! No door entries! Late entries are 
subject to a $25 late entry fee. Send completed forms, $75 mandatory 
registration fee and Cover, Centerfold, Pride of Pageantry and roster 
photos no later than 3/28/03. Photos may be emailed in JPEG format or 
mailed.
No personal checks! Pay by certified funds/money orders only. 
Do not mail cash.
Balance of fees is paid in cash or by certified funds/money
orders at pageant registration. 
Mailing Address: 
Universal CA
 PO BOX 3038
Napa, CA, 94558 

Email: UMMICA@Yahoo.com

FAX /PHONE  
(707) 255-7836: Mary Jean Bruce or (925) 408-9639: Susan Honaker

 

MANDATORY REGISTRATION: Due by 3/28/03
Registration Fee, Family Party Pass, 1 Chaperone Pass, Program Book
$75.00
SELECT ONE PACKAGE:
Package Entry Fees can be paid in advance or at the pageant registration table on the day of the pageant.
PACKAGE A: Divisional Beauty, Glamour, Photogenic and Beauty Supreme. $150.00

PACKAGE B: Divisional Beauty, Supreme Beauty, Glamour, Photogenic, Divisional Modeling, Supreme Model, and Shining Star Supreme.

$225.00

PACKAGE C: Divisional Beauty, Divisional talent, Glamour, Photogenic, Beauty Supreme, Talent Supreme, and Super Star Supreme.

$225.00
PACKAGE D: Divisional Beauty, Divisional Talent, Divisional Modeling, Glamour, Photogenic, Grand Supreme, Baby Grand Supreme, Mini Grand, Beauty Supreme, talent Supreme, Model Supreme, Shining Star Supreme, and Super Star Supreme. $320.00
ADDITIONAL FEES (If any selected)
EXTRA TALENT (1 MAX) $35.00
EXTRA MODEL (1 MAX) $35.00
OR 1 Extra Talent & 1 Extra Model BOTH $60.00
EXTRA PHOTOS (3 MAX) @ $10 each $Due
ADD NOVICE SUPREME
 (Must never have won any National Supreme Title)
$35.00
ADD OVERALL MOST BEAUTIFUL 
(Free if entered by 3/28/03
$35.00
Extra Adult: _____#  @  $10.00 each
Children age 4-12____# @ $5.00 each
$Due
TOTAL ALL ENTRY FEES $Due
DISCOUNTS AND CREDITS
Note - Submit sponsor ads and ad payments no later than 3/28/03. Pageant officials will tabulate correct credit earned toward fees, hotel, future events, and/or the 2003 Grand Ambassador Title.
New Contestant Referral Credit(s): MUST BE NEW to UMMI, pageant system.Refer 1-3: $25 credit per contestant. Refer 4: FREE ENTRY to ANY package! (Does not include extra talent, modeling or photos) $Minus
50% Sibling Discount off entry fees - Siblings pay full registration fee. $Minus
Regional Credit to West Coast: $Minus
TOTAL OF ANY CREDITS/DISCOUNTS $TOTAL
BALANCE OF TOTAL OF ALL FEES $Fees
MINUS ANY CREDITS/DISCOUNTS $Credits
BALANCE DUE AT REGISTRATION $Due
CASH ONLY at registration! No checks will be accepted - NO exceptions!

Referred By:


Email: ummica@yahoo.com

 

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