Name: Age:
Address: City: State: Zip:
Phone: Email: Date of Birth: SS#:
Height: Weight: Bust: Waist: Hips:
Dress: Shoe: School: Year/Class:
Hobbies:
Community Involvement and Volunteer Work:
Clubs and Groups:
Three words that describe you:
Favorite Saying:
Honors and Awards:
Favorite Family Tradition:
What is the greatest challenge facing teens today:
If you are selected for this title what platform or issue will you speak on throughout the year?

Mother's Name: Occupation:
Address: Work #:
Father's Name: Occupation:
Address: Work #:

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