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Please complete all fields. |
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OFFICIAL ENTRY FORM
1999 WILHELMINA MODE MODEL
SEARCH
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Please write clearly: |
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ENTRANT'S
NAME: |
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DRESS SIZE
: |
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| ADDRESS: |
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| CITY: |
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| STATE: |
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ZIP: |
| HOME NUMBER: |
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| BIRTH DATE: |
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AGE CATEGORY:
15-21 22-29 30+ |
| IF UNDER 18 YEARS
PARENT/LEGAL GUARDIAN SIGNATURE: |
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| PAYMENT
METHOD: |
Personal Check (enclosed)
Money Order
(enclosed) |
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American Express VISA MasterCard |
| CREDIT CARD# |
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| EXP. DATE: |
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| SIGNATURE: |
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Send
completed entries with the $20.00 entry fee and photograph to:
1999
Wilhelmina MODE Model Search
PO Box 630859, Dept. 640
Irving, TX 75063
All entries must be postmarked by November
19,
1999
MSWEB |
