Lot 70 Hadfield Street, Lodge, Georgetown,

Ph.: 231-8148 or 665-4565 email:simplimgttp@yahoo.com.

APPLICANTS NAME: ___________________________________________________

ADDRESS: _____________________________________________________________
PHONE NUMBERS: _____________________________________________________
EMAIL ADDRESS:______________________________________________________
FACEBOOK: ___________________________________________________________
DATE OF BIRTH: _______________________________________________________
BIRTH COUNTRY: ______________________________________________________
OCCUPATION: _________________________________________________________
HOBBIES: _____________________________________________________________
STATISTICS: BUST: _____

WAIST: _____

HEIGHT: ____Ft. ____ Inches

HIPS: _____
WEIGHT: ______ Pounds

CAREER GOALS: _______________________________________________________

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PAGEANT TITLES HELD:

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Thank You!!!