Midwest Galaxy Online Entry Form

Please send this form ONLY if you are entering the pageant.  If you simply want more info, please email me at Midwestgalaxy@aol.com

Name

Age

Division

Street Address

City

State

Zip Code

Area Code/Phone

Email

EntryFee  $300

Deposit 

Balance

Entry fees may be paid via paypal at MidwestGalaxy@aol.com.  A deposit of $100 will secure your participation in the pageant.  Please email a photo to MidwestGalaxy@aol.com after sending in your entry form.  If you would like to mail your payment, please mail it to

Ultimate Events

1909 Rex Ct.  New Castle, IN 47362