Miss Earth Congo Beauty Pageant

Application Form

The Miss Earth Pageant has been acknowledged as one of the three biggest international
beauty pageants in the world and the most relevant of them all.
Miss Earth Congo Pageant aims to help women see that through their beautiful and intellectual qualities, they are Rock Stars who can become exceptional role models for not
only Congolese women, but for every woman in the world.
Apply for Miss Earth D.R Congo and Miss Earth Republic Congo (Brazzaville) if you
would like to enter the Pageant.
Entry Fee *
Upon receiving confirmation of your application. The pageant officials will inform you
through email with payment preceding instructions.
$850.00
Save the Dates *
Charlotte North Carolina
July 8-31 2015

Please Fill Out All Contact Information:

First Name : *

Last Name: *

E-mail Address: *

Backup E-mail Address:

Street Address 1: *

Street Address 2: *

City/State/Island: *

Zip/Postal Code: *

Country: *

Phone Number (Home): *

Phone Number (Mobile): *

Phone Number (Work): *

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Personal Background & Vital Statistics:

Age *
Are you between 18 & 25 years of age?
No
Yes
Date of Birth *

Place of Birth *
D.R. Congo or Brazzaville Congo?
Are you single and have never been married? *
No
Yes
Height (Feet/Inches) *
5' 5"
5' 6"
5' 7"
6' 1"
6' 2"
Weight (lbs): *

5' 8"

5' 9"

Swimsuit Size: *

5' 10"

Dress Size: *

5' 11"

6' 0"

Shoe Size: *

Good Moral Character:

Have you ever engaged in prostitution in any form thereof? *

No
Yes

Have you ever participated in any obscene or X-Rated exhibitions

of any sort whether printed, stage, television or movies? *
Yes

No

Have you ever worked as a model, hostess or anything

similar in establishments generally reputed to be 'girlie' joints? *
Yes

No

Have you ever been convicted of any crime? *

No
Yes
Are you familiar with your country's cultural and enviromental
concerns/problems? *
No
Yes

More About You:

Have you always lived in the U.S.? *
Yes

No

If not, what other countries have you lived in? *

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Personal Outlook:
What brings you to the Miss Earth Congo Beauty Pageant? *

Why are you interested in becoming Miss Earth Congo? *

How/what do you hope to contribute? *

What do you want to do as Miss Earth that will benefit the environment,
especially in the Congo? *

Individually, what can you do to benefit the environment around you? *

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Personal Outlook (Continued):

What do you want to get out of the Miss Earth Congo Pageant? *

Please list your hobbies: *

Are there any sports or activities you participate in? *

Please Describe your life's ambition: *

Please list any performable talent(s): *

Please list any title(s) or award(s) won: *

Please list any special training you've had in Music, Dance, Art, etc.: *

Do you speak any other languages? Please select: *

Arabic
Other

Bengali

French

German

Hindi

Italian

Japanese

Korean

Mandarin

Is there a famous person you would like to meet? Please tell us why: *

What is the most unusual thing you have ever done? *

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Personal Outlook (Continued):

Please describe a moment in your life that you are the most proud of: *

What other countries, if any, have you travelled to? *

What is your favorite color? *

What is your favorite food? *

Verification:

PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION EMAIL:

Defining digital photos of yourself, in color. (Must be high resolution, or at least 300 DPI)
Two (2) Photographs of your face, from the shoulders up *
Two (2) Full Body in Swimwear *
Two (2) Full Body in Evening Gown attire *
One 3-minute video of yourself.
Advocacy (2015 Theme: The Light of the Earth)*. Talk about the following in your video:
List two fun Eco Tourism (Environmental Activities) you would like to do as part
of your 'Platform Competition. How will these activities shine 'The Light on the Earth?'
How are you going to get the entire community of North Carolina to get involved
in your awareness?
What kind of media are you going to use to get the word around about your
awareness?
Photocopy of your Passport. *
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Verification (Continued):

I, the applicant, agree that all of the information WKDW,KDYHprovided RQWKLVIRUP

LVWUXe and accurate.
I, the applicant, hereby verify that at the time of the submission of this application,
I am at least 18 years of age, and no older than 25 years of age.
I, the applicant, agree to be bound by the terms and conditions stated in the eligibility
critera for the Miss Earth Congo Beauty Pageant.

Date: *

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