OFFICIAL APPLICATION

MISS BLACK TENNESSEE TALENTED TEEN PAGEANT DEADLINE FOR APPLICATION & ALL FEES – JULY 31ST *High-Resolution (300 dpi jpeg) Head Shot Required Immediately via email to: [email protected]

FULL NAME ______AGE ______BIRTH DATE ______

PARENT/GUARDIAN ______PHONE______

ADDRESS ______CITY ______ZIP______

HOME PHONE ______CELL PHONE______

E-MAIL ADDRESS ______

NAME OF SCHOOL ______GRADE (as of August) ______

SCHOOL ADDRESS ______CITY______ZIP______

SCHOOL PHONE ______PRINCIPAL’S NAME______

DESCRIBE YOUR TALENT FOR THE COMPETITION:______

LIST SCHOOL AND VOLUNTEER ACTIVITIES:

______

______

LIST COMMUNITY, CHURCH, SOCIAL OR CIVIC ACTIVITIES:

______

______

LIST SPECIAL TALENTS AND/OR SKILLS YOU HAVE:

______

______

BY SIGNING BELOW, THE CONTESTANT AND PARENT AND/OR LEGAL GUARDIAN OF THE CONTESTANT HEREIN WARRANTS THAT THE INFORMATION ON THIS APPLICATION IS CORRECT AND ALL INFORMATION REGARDING THE MISS BLACK TENNESSEE TEEN SCHOLARSHIP COMPETITION HAS BEEN READ AND IS HEREBY AGREED TO.

Teen Contestant’s Signature______

Parent/Legal Guardian Signature ______Contestant Parent / Legal Guardian

Date______

For more information contact: Ms. Lynet Payne, Executive Director

Miss Black Tennessee Pageant P.O. Box 2035, Antioch, TN 37011-2035 615-473-5024 / [email protected] missblacktennessee.com / missblackusa.org Note: For overnight and FedEx Packages please call 615.593.0178 for alternate address. RULES AND REGULATIONS

o A contestant must be 13-17 years of age at the time of entry, but must not be 19 on or before the state competition.

o A contestant must be a resident of the state of Tennessee.

o A contestant must not have nor had any children.

o A contestant must have or maintain a good school attendance with passing grades. Report cards will be requested. Contestant must maintain good academic standing in school minimum 2.5 GPA.

o A contestant must have a youthful appearance and be in good health.

o A contestant must furnish all garments required for participation in the contest. All garments must be pre-approved and will be reviewed by the pageant director.

o Each contestant is responsible for the sale of a minimum of ten (10) tickets and one (1) full-page ad for the souvenir booklet. A NON-REFUNDABLE application fee of $25 is required.

o A contestant is required to participate in all activities/segments of the contest.

o At the time of entry, a contestant must not be signed to any management contracts or enter any contract while participating in the contest, and must not enter into or hold a title to any other contest.

o The winner is forbidden to use the title without permission the Miss Black TN Organization.

o Contestant gives permission to Miss Black Tennessee Teen, Miss Black Tennessee USA Scholarship Pageant and Organization, and its licensees, assigned production company and its affiliates, sponsors and publicity representatives of all concerned, to use her photographic likeness, voice and service “gratis” in connection with the contest, including any subsequent recorded or timed excerpts of the contest for commercial purposes.

o Contestant agrees that any conduct on her part at any time, which, in the eye of the director, organizational stakeholders and the public, will discredit the good image of the competition, shall result in the contestant’s immediate dismissal from all contest activities and forfeiture of all rights, titles, fees, and gifts at that time.

o Contestant hereby releases Miss Black Tennessee Teen, Miss Black Tennessee USA Scholarship Pageant and Organization, and their associates, from any activities of any activities of any and all claims for damages or injuries which may sustained while participating in any activities of any contest or during her reign as the winner or first runner up.

BY SIGNING BELOW, THE CONTESTANT AND PARENT AND/OR LEGAL GUARDIAN OF THE CONTESTANT HEREIN WARRANTS THAT ABOVE INFORMATION HAS BEEN READ, UNDERSTOOD AND AGREED UPON.

Teen Contestant’s Signature______

Parent/Legal Guardian Signature ______Contestant Parent / Legal Guardian

Date______CRITERIA FOR JUDGING

Personal Fitness: 20% • Stage Presentation • Overall Appearance • Body Condition • Sportswear Selection

Talent: 35% • Artistic Expression • Technical Skill • Stage Presence • Professionalism • Overall Performance

Evening Gown: 20% • Style • Poise • Grace • Professionalism • Overall Presentation

Question and Answer: 25% • Ability to think fast on feet • Articulation • Composure • Overall Response

I. All attire should represent a youthful teenage appearance but can be creative to reflect the teen’s personality. Shoes should have a modest heel no higher than 2 inches. Gowns should be tasteful with respect to cleavage, straps, design and color.

II. Contestants should prepare a thirty (30) second SPEECH /PRESENTATION to include name, age, city, academic/social/civic achievements, community activities and plans for the future.

III. Talent material performed shall be in good taste with no mature or offensive song lyrics. Time allotted is two (2) minutes. Fire acts are not allowed. All props, musical instruments and equipment required are the responsibility of the contestant.

ANY ATTIRE DEEMED INAPPROPRIATE WILL NOT BE PERMITTED PAGEANT AWARDS

 Winner will receive: $1,000 College Scholarship, One Year Reigning Queen as MBTN Talented Teen Spokesperson, Personal Tiara w/ Case and Official Sash, Represent our State in the National Competition, 3 Tier Trophy, Professional Photo Shoot & Make- Up, Promotional & Endorsement Opportunities, Rose Bouquet, Pageant T-Shirt, Promotional Opportunities in the Community and other consolation prizes.

 First Runner Up will receive: $500 College Scholarship, 2 Tier Trophy, Flower Bouquet, Pageant T-Shirt, Promotional Opportunities in the Community and other consolation prizes.

 Second Runner Up will receive: $300 College Scholarship, 2 Tier Trophy, Flower Bouquet, Pageant T-Shirt, Promotional Opportunities in the Community and other consolation prizes.

 Third and Fourth Runner Up will receive: $100 College Scholarship, 2 Tier Trophy, Flower Bouquet, Pageant T-Shirt, Promotional Opportunities in the Community and other consolation prizes.

 All competing contestants will receive: Official Pageant Certificate, Pageant T-Shirt, Promotional Opportunities in the Community and other consolation prizes.

 Special Awards: Miss Photogenic, Congeniality Award, Community Service Award, People’s Choice Award, Academic Excellence Award, Executive Award (person who sells the most ads/tickets)