WELCOME TO THE OFFICIAL WEBSITE OF MISS INDIA NORTHERN CALIFORNIA

Full Name*
First Name Last Name
Marital Status*
Nationality*
Present living situation (i.e. alone, with parents, college, spouse, children):*
Emergency Contact (Include full name and phone)*
Relationship (to Emergency Contact)*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
Type of disability if any (cause and date of onset). If not, answer with NA.:*
Education*
Employment*
Employment Position*
Place of Employment*
Family (parents, siblings, children, etc.)*
Volunteer/Community Involvement*
Achievements (awards, special recognition, leadership, other honors earned or received)*
Philosophy about life*
Please choose five words that best describe you*
Tell us why you believe the judges should select you as winner of Miss India Northern California Pageant?*
Other information (information you would like the judges to know about you such as hobbies, travel, etc)*
Talents (3 minutes max. describe in a few words):*
E-mail*
I hereby certify that the above information is true to the best of my knowledge.

**I understand and I agree to abide by all pageant rules. I further agree not to hold Miss India NorthernCalifornia pageant, directors, staff or facilities of pageant responsible for any injuries, losses, damages, thefts, or accidents, which may occur, at any Miss India Northern California pageant, or while traveling to or from any event. I understand that judge’s decisions are final. Any act of bad sportsmanship from contestants or family member will NOT be tolerated and will result in disqualification. By signing this form, I also release use of any pictures taken at the pageant to be used for advertising purposes. Miss India Northern California Directors reserve the right to refuse entry to anyone. Miss India Northern California Directors reserve the right to refuse entry to anyone.
Signature (Full Name)*
First Name Last Name
Date*
- Month - Day at Year / Hour Minutes
Witness/Parent/Guardian if under 18 years of age
First Name Last Name
Before you click on the submit button below, please be sure that information entered in the above fields are correct.
Requirements for completing the registration process:

1. The above completed Application Form
2. Photos of yourself (full body, half body, head shots). Send your pictures via email along with your name to Shekhar Rahate.
Should be Empty:

Requirements for completing the registration process: 1. The above completed Application Form 2. Photos of yourself (full body, half body, head shots). Send your pictures via email along with your name to Shekhar Rahate.

Requirements for completing the registration process:

1. The above completed Application Form
2. Photos of yourself (full body, half body, head shots). Send your pictures via email along with your name to Shekhar Rahate.