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PAGEANT CATEGORY*
- Miss Oregon Teen USA(14-18)
- Miss Oregon USA(18 or older)
TODAY'S DATE*
CONTESTANT'S FULL NAME (and if you go by a nickname, please include it in parenthesis. (For example, if your name is Katy but you go by Kat, then you would input in the First name column: Katy (Kat)
First Middle Last
LIST TWO (2) LOCAL TITLE CHOICES (for example if you're in the 14-18 division: Grants Pass Teen, Multnomah County Teen, Crater Lake Teen, Columbia River Teen, etc. and if you're in the 18 or older division, then: South Eugene, Greater Portland, Downtown Bend, etc.)
DATE OF BIRTH*
MM slash DD slash YYYY
CONTESTANT'S ADDRESS*
Address City State ZIP Code
CONTESTANT'S CELL#*
EMAIL ADDRESS (please try not to use school/university email addresses and instead a personal email address)*
Enter Email Confirm Email

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