I am applying to be a contestant in: *

Miss Indiana USA

Miss Indiana Teen USA

Name

First Name

Last Name

Phone *

(###)

###

####

Best phone number to reach you at *

(###)

###

####

Birthday *

MM

DD

YYYY

Guardian's Name

First Name

Last Name

Guardian's Phone Number

(###)

###

####

How did you find out about the pageant? *

Select any that apply and if other, please let us know.

I have always dreamed of being a titleholder

I watched the Miss USA pageant on TV

A friend or family member suggested I apply

A friend or family member was in a pageant

I saw an ad on Facebook

I saw an ad on Instagram

Other

I represent and warrant that I am a female (recognized medically and legally as a female in the United States): *

I AGREE

I DO NOT AGREE

Teens Only: I am single, have never been married:

I AGREE

I DO NOT AGREE

Teens Only: I do not have a child and have not given birth to a child:

I AGREE

I DISAGREE

I am a United States citizen: *

I AGREE

I DO NOT AGREE

At least one of the statements below is true: *

(1) I have been or I will be a resident of the state of Indiana for at least ninety (90) days prior to the state pageant. OR (2) I have resided in Indiana as a full-time student at a school, college or university for one full semester, trimester, or summer session immediately prior to the state pageant, and still enrolled as a full-time student at a school, college or university and will continue to reside in Indiana (although I may spend the summer in another state). (3) I work at least forty (40) hours per week in Indiana, qualify for employment benefits provided by my employer, and have maintained such full-time employment for a period of at least ninety (90) days prior to the date of the State Pageant.

I AGREE

I DO NOT AGREE

I meet the age requirements for this year’s pageant: *

Miss: At least 18 by Jan 01, 2025 (no age restriction)

Teen: At least 14 and under 19 by Jan 01, 2025.

My friends name

First Name

Last Name

My friend would enter

Teen Pageant (ages 14 - 19)

Miss Pageant (ages 18+)