4857 Baxter Rd, Virginia Beach, VA 23462
littlemisspiva@gmail.com
757-687-0392
Search
Home
2020 Little Miss Philippines of Virginia & Court
Prospective Contestants and Parents
Prospective Contestant Application
About
Contact
Prospective Contestant Application
Parents of prospective contestants should complete the following form and the Pageant Committee will contact you soon!
Event Date:
Saturday, February 8, 2020
Event Time:
2:00 PM
Location:
Philippine Cultural Center of Virginia
Please enable JavaScript in your browser to complete this form.
Contestant Name
*
First
Middle
Last
Contestant Nickname:
If none, leave blank.
Date of Birth:
*
example: October 26, 2010
School Name:
*
Grade:
*
First Parent's Name or Guardian's Name
*
First
Last
First Parent/Guardian's Address:
*
street, apt# (if applicable), city, zip code
First Parent/Guardian's Email Address:
*
Email
Confirm Email
First Parent/Guardian's Home Phone:
*
for example (no dashes or periods, numbers only): 7579891234
First Parent/Guardian's Work Phone:
*
for example (no dashes or periods, numbers only): 7579891234
First Parent/Guardian's Cell Phone:
*
for example (no dashes or periods, numbers only): 7579891234
Second Parent's Name or Guardian's Name:
*
First
Last
Second Parent/Guardian's Address:
If different from above otherwise, leave blank
Second Parent/Guardian's Email Address:
*
Email
Confirm Email
Second Parent/Guardian's Home Phone:
for example (no dashes or periods, numbers only): 7579891234
Second Parent/Guardian's Work Phone:
*
for example (no dashes or periods, numbers only): 7579891234
Second Parent/Guardian's Cell Phone:
*
for example (no dashes or periods, numbers only): 7579891234
Names and Ages of Siblings of Contestant
*
for example: John Smith - 7 yrs old, Jessica Smith - 15 yrs old
Emergency Contact Name:
*
First
Last
Emergency Contact Address:
*
street, apt# (if applicable), city, zip code
Emergency Contact Relationship:
*
ie: Auntie, Uncle, etc.
Emergency Contact Phone Number:
*
for example (no dashes or periods, numbers only): 7579891234
Name
Submit
Prospective Contestant Application
Parents of prospective contestants should complete the following form and the Pageant Committee will contact you soon!
Event Date: Saturday, February 8, 2020
Event Time: 2:00 PM
Location: Philippine Cultural Center of Virginia