MISS CHIOS 2008 APPLICATION

(Panchiaki Korais Society Inc.)

To be held on Saturday, March 1^st 2008 at the luxurious Sand Castle of Long Island located at 519 Franklin Square, NY.

Instructions

Please print or type the application. You may mail, e-mail, or bring it with you the night of the pageant. Age of participants: 16-26 years old. Good luck!

Last Name_______________________________ First Name________________________________________

Address__________________________________________________________________________________

Home Tel #___Bus Tel #

Birth Date _____________________________________ Birth Place ________________________________

Father’s Name __________________________________His Birth Place _____________________________

Mother’s Name__________________________________ Her Birth Place ____________________________

Grandfather’s Name _____________________________His Birth Place ____________________________

Grandmother’s Name____________________________ Her Birth Place____________________________

EDUCATION LOCATION GRADUATION YEAR DEGREE

High School _______________________________________________________________________________

College ___________________________________________________________________________________

Other ____________________________________________________________________________________

BUSINESS EXPERIENCE NAME/ADDRESS POSITION

Present___________________________________________________________________________________

Prior_____________________________________________________________________________________

Ambitions, Hobbies, Talents and Interests ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please use an additional piece of paper or the back if you need more space.

I HEREBY DECLARE THAT: The above information is true to the best of my knowledge and agreed to participate in the contest voluntarily and if elected to represent the Society in a manner that will not cause any embarrassment to its good name. I will also refrain from taking part in any other like pageant within (s) one year from the date of the pageant. I also agree to accept the decision of the judges as final and I will have no monetary or other claims against the Organization except those authorized by it. I am also declaring that I was not and I am not married. Should any of the above proves to be false, I will be obligated to return all gifts besides losing my title as MISS CHIOS 2008.