2016
I HEREBY APPLY AS AN ENTRANT FOR THE TITLE MRS. VIRGINIA AMERICA
DATE OF ENTRY________________________
CHOICE OF TITLE ONE __________________________________________ CHOICE OF TITLE 2 ___________________________________________
______________________________________________________________________________________________________________________________
NAME
HOME PHONE
MOBILE
______________________________________________________________________________________________________________________________________________
HOME ADDRESS – CITY
-STATEZIP CODE
E-MAIL
______________________________________________________________________________________________________________________________________________
AGE
DATE OF BIRTH
BIRTHPLACE
U.S. CITIZEN
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HEIGHT
WEIGHT
EYE COLOR
HAIR COLOR
BUST-WAIST-HIPS
SHOE
DRESS
SWIMSUIT
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MARRIAGE (Month/Day/Year)
OCCUPATION & ADDRESS OF EMPLOYER
_____________________________________________________________________________________________________________________________________________
HUSBANDS NAME
CHILDREN’S NAMES & DATE(S) OF BIRTH
______________________________________________________________________________________________________________________________________________
NAME & LOCATION OF SECONDARY SCHOOL: __________________________________________________________________________________________________
NAME & LOCATION OF COLLEGE, UNIVERSITY OR OTHER:_______________________________________________________________________________ _________
LEVEL REACHED:
DEGREE(S):_____________________________________________________________________________
DESCRIBE CURRENT & RECENT COMMUNITY INVOLVEMENT:______________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
HOBBIES, TALENTS & GENERAL BACKGROUND:___________________________________________________________________________________________________
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RULES AND REGULATIONS
Entrant must be married as of the date of entry and throughout the state and national competitions
Entrant is and always has been a female and is at least 18 years of age as of the date of entry
Entrant will continue to be a person of good moral character; affirms that she has not committed and will not commit any act inconsistent with the highest standards of public morals and
conventions or that will reflect unfavorably on the Pageant, its representatives, sponsors and or/licensees; that during her majority (18 years of age or older), she has not willingly appeared in
provocative and sexually explicit photographs for any film, video, or publication prior to, during the state pageant, or during her reign as a state winner or as “Mrs America.”
Entrant must be a U.S. Citizen and a resident of the State she represents and must have permanently resided there for at least three consecutive months immediately prior to her entry into the
State Competition (residence at a military installation is acceptable.) If the “State” Entrant seeks to represent in the District of Columbia, she must either (a) reside in the District of Columbia
(residence at a military establishment is acceptable) or (b) work in the District of Columbia on a full-time basis (live within a 25 mile radius) and she must have done (a) or (b) for at least the
last three (3) months prior to her entry into the Competition
Entrant is only permitted to enter one state pageant per pageant year, and must follow rules outlined above (number 4).
Entrant agrees to look solely to the State Director with respect to all matters relating to the State Pageant, including her application to enter the State Pageant, the preparation, rehearsal,
performance and selection process relating to the State Pageant and all other matters relating to the State Pageant. Mrs. America, Inc., its officers, directors, agents and employees are not
liable to entrant for anything whatsoever in connection with the State Pageant
Entrant will attend the Mrs. America Pageant (sometimes referred to as the “National Pageant”) if selected as the Winner in the State Pageant and further abide by all the required services,
rules and regulations governing this National Pageant. Entrant is responsible to both Mrs. America and her State Director in the event of non-compliance with the same.
Entrant may have a modeling, personal management and/or agency contract, which contract, however, does not include, authorize, or permit the use of the name of “Mrs. America Pageant” or
any title designation or reference with respect to the Pageant in any manner. Entrant may not have any commercial tie-up or endorsement agreement or commitment of any kind whatsoever
Entrant agrees to be bound by the rules, regulations and the Contestant Agreement required by Mrs. America, Inc.
No person may compete in the National Pageant more than once. A Contestant may enter the State competition more than once if she is not the winner. A State winner may not enter
the same state pageant again. If a contestant moves to a different state, she may enter her new state of residence only if she has never competed at the National Pageant. (SEE #12 and #16)
A contestant may not participate as a contestant in another pageant for married women while holding a city, county, or state title in the Mrs. America system.
Relative to State matters, the Directors shall have the final approval of wardrobe, appearances, press releases, coaching and hair and make-up providers.
Failure of a contestant to abide by the rules above may result in disqualification and or removal of a State title at the discretion of the State Director, subject to review by the National Pageant
Grievance Committee.
Applicant hereby authorizes the use of any pageant photos or video reproduction of the applicant at the state pageant for pro motional purposes.
Mrs. America, at its discretion, may conduct separate contests, such as a: “1 st Runner-Up” or “Fabulous Face” Contest and add Delegates to the National competition. The winner of the “1 st
Runner-Up Contest” may compete again at her State or National competition provided that she does not win Mrs. America.
As consideration for this agreement, Contestant promises to pay the respective State entry fee.
The winner of the state competition is required to purchase, at her own expense, a full page advertisement in the Mrs. America program book, (Currently $1000; subject to change)
I agree to be bound and abide by all the Rules and Regulations herein set forth. Signature of Applicant_____________________________________________________________________________
Signature of Director___________________________________________________________________________________
Mrs. America is a registered trademark of Mrs. America, Inc. Mrs. World is a registered trademark of Mrs. World, Inc.
2412 Wilshire Boulevard Suite #204 Santa Monica, CA 90403 Telephone: (310) 829-9902 Fax: (310) 828-5862 e-mail: info@mrsamerica.com
Return Application Plus $200 Deposit and Snapshot to: Popeproductionsva@yahoo.com PO Box 1883, Midlothian Va 23113
Phone (804) 387-6835 Email: brandi@mrsvirginia.com
This could be you. But first you must enter!
This is your chance to join us for one
of the most exciting and fun events in
Virginia!
We are looking for bright, positive, married women
who want to challenge themselves, gain more selfconfidence, and be recognized for their
achievements. The Mrs. Virginia America
Competition is an exciting and rewarding program
that recognizes Virginia’s married women and is
the only official state preliminary to the prestigious
Mrs. America Pageant. Mrs. Virginia will join 50
other state winners at the national Mrs. America
pageant.
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Download an application at www.mrsvirginia.com
Type or print your application
Enclose a snapshot or photo. Please put your name on the back of the photo.
Sign your application
Enclose your $200 Registration Fee. (refunded if you are not selected as a
contestant. Please understand it is our long standing policy that there are no
refunds on any fees that you or someone has paid on your behalf once you
have been accepted. )
Make Checks or Money Order payable to Pope Productions LLC and mail
to the address below.
Pope Productions LLC
PO Box 1883
Midlothian Va 23113
PLEASE RETURN YOUR APPLICATION WITHIN 14 DAYS. If you
need more time, please call 804-387-6835. Office hours are Monday-Friday
8am-6pm. If you are selected as a contestant, you will be notified within two
weeks and receive your official registration packet.
AWARDS:
The following awards are presented: Congeniality, Photogenic, Director's Award,
Ticket Sales, Memory Book Award, Evening Gown Award, Non-Finalist Evening Gown
Award, Fitness Award, Non-Finalist Fitness Award, Interview Award, Non-Finalist
Interview Award, Community Service Award, Contestant's Choice, Marriage Longevity,
Ambassador Award, Best Smile Award, Career Achievement Award, Facebook Award,
Fabulous Face Award, Top Five and Mrs. Virginia.
Sponsors Help Cover Expenses
Fees cover the opening number outfit, contestant
meals, the official photo package, official Mrs.
Virginia 2016 video, Husband and Wife Party,
Complimentary Husband Ticket to the Final
Show, and a complimentary copy of the Mrs.
Virginia Official Souvenir Program. The
participation fee is $595, and may be shared by
businesses, friends, and family members. The
participation fee is in addition to the registration
fee. Sponsors are advertised in the Official
Program book. Upon issuance of your title, you
will be awarded a beautiful satin, custom
embroidered banner bearing your local title.
RULES AND REGULATIONS:
Delegate must be at least 18 by date of state pageant. She must
have been born female, married, a resident of Virginia and a US
citizen. Delegate must be of good moral character and never
convicted of a felony. Delegate must pay in full the registration
and participation fees. Delegate must sell ten (10) tickets to the
2016 Mrs. Virginia pageant. Each ticket is $35 and includes the
official Mrs. Virginia Program book (a $10 value)
AREAS OF COMPETITION:
*Personality and Communication skills = 50%
-A panel of judges will critique each delegate’s ability to communicate,
her personality, her self-expression, her achievements and her
beauty.
*Fitness and Health = 25%
-Delegates will compete in a one or two piece swimsuit style of their
choice. (color tbd by director).
*Poise in Evening Gown = 25%
-Delegates will be judged in an evening gown of their own choice.
Mrs. Virginia Pageant ~ P.O. Box 1883 ~ Midlothian VA 23113 ~804-387-6835 www.mrsvirginia.com