Miss Appearance Request

Today's Date*
Organization Name*
Event Title/Description*
monthly meeting, fundraiser/gala, awards banquet, etc
Event Location*
include address
(If you are not tied to a specific date, please list alternative dates or a range of date options)
Day*
Date*
Time of Appearance*
(from/to)
Expected Number of Attendees*
Please list any VIPs confirmed attendance for your event.*
Who would you requesting for a Personal Appearance?
- Miss Oregon USA®
- Miss Oregon Teen USA®
- Both Titleholders
Sometimes, due to scheduling or other conflicts, Miss Oregon USA and/or Miss Oregon Teen USA may not available. Would you be interested in the opposite titleholder or a former state or local titleholder as a substitute?
- Yes
- No
What would you like Miss Oregon USA and/or Miss Oregon Teen USA to do at your event?
(Give talk, emcee, kick-off/start walk/run, etc.)
Additional Information/Notes
(if/any)
Have we emceed this/other events in the past for your organization?*
(If so, when and which Miss Oregon USA and/or Miss Oregon Teen USA?)
Name of person making request*
Title
(principal, club/org. president, etc.)
Phone Number(s)*
Email*
What is your budget for this appearance?*

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