REGISTRATION


Entrant's Full Name:

Date of Birth:

Age on Dec 19th, 2005:

Street Address:

P.O. Box:

City & Island:

Home Phone:

Name of School:

Grade Level:

Name & Street Address of Home Church:

Talent: (Check all that apply) Singing Drama/Speech Dancing Playing an Instrument
Other (please explain)

Clubs/Extracurricular Activities:

Honours & Awards:

Hobbies:

Favourite Food:

Favourite Colour:

Favourite TV Show:

Favourite Song:

Mother's Name:

Workplace:

Email:

Work Phone :

Cell:

Father's Name:

Workplace:

Email:

Work Phone :

Cell:

E-mail address?

DECEMBER 18TH, 2005 NASSAU, BAHAMAS

OUR LITTLE MISS-BAHAMAS DIVISION 2005