2009 National Delegate Application
 
 If you are from the state of Louisiana, click here.
 If you are from Oklahoma, click here.
 If you are from Texas, click here.

If you do not have one or more of the numbers above, just re-enter your primary phone number.

Please recheck your contact information.  If we cannot contact you, your application may not be processed or accepted.

 (mm/dd/yyyy)

FOR NATIONAL MISS PLUS AMERICA ENTRANTS ONLY:
Scroll down for individual state entrants

By submitting this information, I understand that, I must remit my state title reservation of $100 or greater within the next ten business days or my state title will be released for other applicants to pursue.  

I understand that if I am not making payment in full, of my entire entry fee (optional competition fees included), I must contact the national office within ten business days to make acceptable payment arrangements.  I  understand that if I fail to make a scheduled payment (per my individual payment plan) without prior notification and future payment arrangements, I will lose my title and any fees paid in to the Miss Plus America Pageant.

I also understand that I will not receive my crown/banner/state packet until my paperwork is turned in and my entry fee is paid in full or I forfeit my title and any monies paid to Coronet Productions for the purpose of competing in the Miss Plus America Pageant.

Failure to meet  my payment obligations may result in your removal as a state queen and as a delegate to the Miss Plus America national competition, at which time I will be forbidden from making any reference to an association with Miss Plus America Pageant system.  If this should occur, Miss Plus America Pageant System reserves the right to award my title to another delegate.

I understand that there are NO REFUNDS UNDER ANY CIRCUMSTANCES.

I attest that I am a pant size 14W or greater as defined on the Frequently Asked Questions Page.

I understand that I am responsible for selling a total of two final night tickets @ $35.00 each and two Plus America "Viva La Diva Party"  tickets @ $40 each...a total of $150.

I understand that I am responsible for selling one full-page ad for the program book... a total of $150.

I have read and agree to adhere to the Miss Plus America Official Rules and Code of Conduct. (Click links to read)

I understand that this application is not complete until my $100 State Title Reservation is received by the Miss Plus America Headquarters.

*All applicants must submit and a photo to National Director, Melissa Stamper at director@missplusamerica.com  for the purpose of delegate page display.  Sponsor names, addresses and websites may be submitted at this time.

I give Coronet Productions and Miss Plus America permission to use my likeness for the purposes of promotion of the Miss Plus America Pageant and myself as an official state delegate of the national Miss Plus America pageant.

Please consider that MPA is a self sufficient pageant.  If you are not positively sure you will be able to attend the pageant for competition, please do not apply.  It is not fair to another who could hold the title and attend.  

I acknowledge that I have read and understand the Frequently Asked Questions page as well as the Rules and Regulations set forth on the Rules and Regulations page  I also attest that I have read, understand and will adhere to the official Code of Conduct as set forth on the Miss Plus America Code of Conduct page.

  NO