Contract Request Form

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Thank you for your interest in the Miss Johnston County & Miss Cleveland and Miss Smithfield Scholarship Organization. Join us as we crown 5 NEW Queens December 9, 2023 at 5:00 pm. Please provide us with more information below and we will send you the required contracts to compete in our organization.

What is your name? (First and Last) *

What is your email address? *

What is your phone number? *

What is your home mailing address? *

What county do you reside in? (If you are a Carolina Star, please just type Star) *

How old are you? *

What is your birthdate? *

YYYY

What school/university do you attend? *

What talent will you be performing? *

Please select one of the following *

I am competing as a Miss Candidate

I am competing as an Teen Candidate

I am participating as a Carolina Star

MANDATORY REHEARSALS

December 2nd (Miss and Teen Candidates only in Benson, NC)

December 3rd (Carolina Stars only in Benson, NC)

December 8th (All Candidates & Carolina Stars) at Cleveland High School, Clayton, NC

Yes, I will in attendance

I have a conflict of interest with one or more dates

Have you registered on the Miss America Portal? *

Yes, I have

No I have not

I'm not sure what this is

If you are a Miss Candidate, will you be competing as Miss Cleveland or Miss Johnston County? (Miss Cleveland is our 'open' title and you can reside in any NC county, Miss JoCo is our 'closed' title and you must reside within our eligibility requirements (outlined on our website *

Miss Johnston County (closed title, must reside in specific counties)

Miss Cleveland (Open title, can reside in any NC county)

I'm not sure yet

Please choose one to let us know if you'd like additional support in your registration/paperwork process. *

I am new to the organization; I would like additional support in my registration process to compete

I don't need support at this time, I am familiar with the steps and organization.

I may need additional support at a later time.

Additional feedback, if needed

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