Candidate Information Form

Candidate Information Form (The 48 Hour Form)

Thank you for taking the time to submit this important information related to your participation in the Miss Iowa and Miss Iowa's Outstanding Teen competition. This information should be submitted within 48 hours of winning a local program title. If information changes throughout the year and as Miss Iowa week approaches, you may resubmit the entire form as often as necessary. The information with the most recent submit date will always be used and previous submissions will be deleted. Please email executivedirector@missiowa.com with any questions.

* Indicates required field

Competition Level *

Local Program or Title *

Candidate's Full Legal Name *

Candidate's Nickname *

Contact Email *

Candidate Contact Cell Phone Number *

Text Messaging *

Please text me with important information and updates related to competition

Emergency Contact Number *

Birthdate mm/dd/yyyy *

Age (as of June 11, 2021) *

School or College *

Grade or Year of Study and Major if applicable *

Talent *

Social Impact Initiative (Miss) / Platform (Teen) *

T-shirt size *

Permanent Mailing Address (please provide an address where mail can be received year round.) *

Line 1

Line 2

City

State

Zip Code

Country

Parents'/Guardians' Full Name (First and Last Names of Both Parents. Please list separately if divorced or separated) *

Parents'/Guardians' Primary Contact Cell Phone Number *

Local Executive Director(s) *

Submit