EmailMe Form - Miss Showgirl Entry Form

Full Name *

Address *

Street Address City State / Province / Region Postal / Zip Code

Phone *

Email *

Date of Birth *

DD / MM / YYYY

Occupation *

Nominating Society *

Sub Chamber *

Entrants Declaration *

I have read and understood the “Miss Showgirl Awards Conditions of Entry” and agree to be bound in all respects by these “Conditions of Entry” and the Rules & By-Laws of QCAS

I hereby declare that to the best of my knowledge and belief all matters and information provided on this Nomination Form are true and correct.

The information supplied by me on this form is not to be disclosed to anyone not associated with the Miss Showgirl Awards without my written consent.