Miss Black Iowa USA

Miss Black Iowa USA
is an affiliate of
Miss Black USA

Please use the following online application.

Fill out the online application form below and someone from Miss Black Iowa will be in contact with you soon.

Application For
Name (First, Middle, Last):
Email Address:
Age:
Date of Birth (mm/dd/yr):
Home Phone
Work Phone
Cell Phone
Mailing Address:
City / State / Zip:
Permanent Address:
City / State / Zip:
Emergency Contact Name:
Emergency Contact Phone:
Height / Weight:
Dress Size / Shoe Size:
Measurements - Bust / Waist / Hips
School / College / University
Highest Grade Completed
Major / GPA / Graduation Date
Special Talents & Training:
List any Honors & Awards
What Talent Will You Perform? Note: Talent must be 2 min & 30 sec. (you will be given an additional 15 sec. grace period)
How Did You Hear About the Competition?
Being Miss Black Iowa USA is an honor of high esteem that requires service, sacrifice, and commitment. The personal rewards are many. Describe your level of commitment, time management abilities, and your reason(s) for wanting to pursue the title. (Minimum 100 words)

I agree that I have read and understand the application process. I further agree that I meet all of the requirements of the national Miss Black USA Pageant. I understand that falsification of this application is grounds for immediate disqualification and forfeiture of any and all fees paid.


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