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Miss Africa Australia Online Registration Form

Contestant’s Name

Phone

Date of Birth

Country of Birth

Parent’s/Guardian’s Name

Home Address

School/University

Career goals or personal interests

Extracurricular activities, scholastic programs, community services, hobbies

Agreement

I hereby certify that the information provided herein is factual and correct. By signing this registration form, I agree to comply with the Rules and Regulations of the Miss Africa Victoria Australia Pageant. Furthermore, I give the pageant coordinators permission for the above information to be released to the news media for the purpose of promoting this pageant, sponsors and any events affiliated with said pageant.

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