APPLICATION

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0><script type="text/javascript" src="http://hb.lycos.com/hb.js"></script> <script type="text/javascript" src="http://ratings.lycos.com/ratings/lycosRating.js.php"></script> <script type="text/javascript"><![CDATA[//><!]]></script> <script type="text/javascript" src="http://scripts.lycos.com/catman/init.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-start.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-middle.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-end.js"></script> <noscript> <img src="http://members.tripod.com/adm/img/common/ot_noscript.gif?rand=169481" alt="" width="1" height="1" />  <iframe frameborder="0" marginwidth="0" marginheight="0" scrolling="no" width="728" height="90" src="http://ad.yieldmanager.com/st?ad_type=iframe&ad_size=728x90&section=209094"></iframe>  </noscript> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=3 height=85 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="04b00d20egerdp.jpg"> <div> <B>MISS KANSAS COED 2002 </b></div> <div> <A HREF="request_info.htm" TARGET="_top" TITLE="REQUEST INFO"><U><IMG SRC="03c070e0.gif" border=0 width="7" height="14" ALT="previous" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A>     <A HREF="book_store.htm" TARGET="_top" TITLE="PAGEANT BOOK STORE"><U><IMG SRC="03d070e0.gif" border=0 width="7" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A>      <IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14">  <A HREF="index.htm" TARGET="_top" TITLE="Miss Kansas Coed 2002"><U><IMG SRC="03f0e0e0.gif" border=0 width="14" height="14" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> </td> </tr><tr> <td valign="top" rowspan="2" width=210 BGCOLOR="#FFFFFF" TEXT="#080000" background="1d20a0a3.gif"> <div> <IMG SRC="3f54b2e0.gif" border=0 width="75" height="46" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="138" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" BGCOLOR=#000099 > <tR> <tD VALIGN=TOP HEIGHT= 174 ><NOBR><div> <IMG SRC="0517d8e0.jpg" border=0 width="125" height="142" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div>  <img src="HTMLobj-1005/aniGif.gif" border="0" align="bottom" width="85" height="18">  </div> </NOBR></tD> </tR> </TABLE></div> <div>  <img src="HTMLobj-1006/aniGif.gif" border="0" align="bottom" width="68" height="50">  </div> </td> <td valign="top" height=363 colspan=2 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B>MISS KANSAS COED 2002</b><B> </b><FONT SIZE="1" COLOR="#0000BF" FACE="Arial" > |     <A HREF="index.htm" TARGET="_top" TITLE="Miss Kansas Coed 2002"><U>home</U></A></FONT></div> <div> <A HREF="bio_of_miss_kansas.htm" TARGET="_top" TITLE="BIOGRAPHY"><U>BIOGRAPHY</U></A>   |   <A HREF="contact_page.htm" TARGET="_top" TITLE="CONTACT ME"><U>CONTACT ME</U></A>   |   <A HREF="appearance_schedule.htm" TARGET="_top" TITLE="APPEARANCES"><U>APPEARANCES</U></A>   |   <A HREF="kansas.htm" TARGET="_top" TITLE="MY HOME STATE"><U>MY HOME STATE</U></A>   |   <A HREF="sponsor_page.htm" TARGET="_top" TITLE="SPONSORS"><U>SPONSORS</U></A>   |   <A HREF="photo_album.htm" TARGET="_top" TITLE="PHOTOS "><U>PHOTOS </U></A>   |   <A HREF="links.htm" TARGET="_top" TITLE="LINKS"><U>LINKS</U></A>   |   <A HREF="request_info.htm" TARGET="_top" TITLE="REQUEST INFO"><U>REQUEST INFO</U></A>   |   <B>APPLICATION</b>   |   <A HREF="book_store.htm" TARGET="_top" TITLE="PAGEANT BOOK STORE"><U>PAGEANT BOOK STORE</U></A></div> <bR> <div> APPLICATION</div> <div>  <table border="2" height="409" width="632"> <center> <tr> <td height="84" width="644" valign="top"> <p align="center"><font size="2"><font face="arial" color="#ff2ca3">To receive more pageant information, print and complete the entry form below. Type or Print Neatly <br>  Mail the </font> <font face="arial" color="#ff2ca3">form along with the $20 application fee to <br> <a href="main1.shtm" target="_parent">American Coed Pageants, Inc. </a><br> 4120 Piedmont Road, Pensacola, FL 32503<br> <a href="#" onClick="window.print();return false">Click here to print this page</a> | <a href="javascript:history.go(-1);">Previous Page</a></font></font></td> </tr> <tr> <td height="49" valign="top"> <form> <font size="2"> <input type="CHECKBOX" name="category" value="coed"> <font face="arial" color="#ff2ca3">Coed: Born 1981-1984        <input type="CHECKBOX" name="category" value="teen"> Teen: Born 1985-1986               <input type="CHECKBOX" name="category" value="teen"> Jr. Teen: Born 1987-1989 <br> </font> <input type="CHECKBOX" name="category" value="sweetheart"> </font><font face="arial" color="#ff2ca3" size="2">Preteen: </font> <font face="arial" color="#ff2ca3" size="2">Born 1990-1992    <input type="CHECKBOX" name="category" value="princess"> Sweetheart: Born 1993-1995     <input type="CHECKBOX" name="category" value="princess"> Princess: Born 1999-1996</font> </form> </td> </tr> <tr> <td height="312" valign="top" align="left"> <div align="left"> <pre><font face="Times New Roman" size="2"><br>Name</font><font face="Times New Roman" size="1">____________________________________________________________________________________________________________________ (first) (last) (middle)<br><br> </font><font face="Times New Roman" size="2">Address </font><font face="Times New Roman" size="1">_________________________________________________________________________________________________________________ (number & street) (or P.O. Box or Apt.)<br> __________________________________________________________________________________________________________________________ (city) (state) (Zip)</font><font face="Times New Roman" size="3"><br> </font><font face="Times New Roman" size="2">Parent's Name(s)</font><font face="Times New Roman" size="3">_________________________________________________________________<br> </font><font face="Times New Roman" size="2">Home phone</font><font face="Times New Roman" size="1">_____________________ </font><font face="Times New Roman" size="2">Age _____ Date of Birth________ Email Address________________________ Grade: Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12 College Other Grade Point Average: A B C (circle one) <b>School and Community Activities, Awards, Talents, Hobbies, etc.:</b> On the lines below, list activities in order of importance - most recent and most important first. Use outline form.<br>Give year of activity or award, if possible. You may list your activities for the past three years. You may attach one <br>extra sheet. For Princess Contestants, list any activities where your contestant interacts with others; for example: <br>preschool, day care, or church.</font><font face="Times New Roman" size="1"> <br> </font><font face="Times New Roman" size="2">____________________________________________________________________________________________<br> ____________________________________________________________________________________________<br> ____________________________________________________________________________________________<br> ____________________________________________________________________________________________</font></pre> </div> </td> </tr> <tr> <td height="18" valign="top"> <table width="100%" border="0" cellpadding="0" cellspacing="0"> <tr> <td width="644" height="14"><font size="3"> <font face="arial" color="#ff2ca3"><b>Rules and regulations:</b></font></font><font face="arial"><font size="1"><br> 1. Contestant must compete in pageant for her age group.<br> 2. Contestant may not have ever been married or have a child.<br> 3. Contestant must compete in pageant for the state where she resides.<br> 4. Decision of the judges is final and scores confidential.<br> 5. The contestant whose name is signed below gives permission to American Coed Pageants, Inc., to use her photograph, speeches, video, etc., for publicity purposes and future pageant material. They become the property of the pageant.<br> 6. <b>Sponsor fees and registration fees are non-refundable.</b><br> 7. In consideration for being accepted as a contestant in one of the American Coed Pageant, we, the parents and/or guardians of the of the contestant individually named below, do hereby release American Coed Pageants, Inc., it's directors, staff, employees and servants from any and all claims of damages directly or indirectly resulting from named contestant participating in one of the American Coed Pageants.<br> 8. It is agreed and understood that any scholarships or college allowances which are part of the American Coed Program are provided by the named college and the amount of such scholarship is determined by the college. American Coed Pageants, Inc., shall have no liability in regard to such scholarships, either as to amount or performance.<br> 9. </font></font><font face="arial"><font size="1">The State Pageant Winner will be asked to sign a contract for the year of her reign which spells out awards and prizes won, as well as responsibilities of the winner, If the State Winner does not sign the contract she will forfeit her State Title, all prizes and cash awards. If for any reason a State Winner is disqualified or unable to attend her National Pageant, she will return any cash awards and/or scholarships, crown, banner, and trophy.</font></font></td> </tr> </table> </td> </tr> </center> </table> </div> <table border="0" width="626" align="center"> <tr> <td> <div align="left"><font face="arial" size="1">_________________________________________________________<br> Applicant's Name or Signature</font></div> </td> <td> <div align="left"><font face="arial" size="1">_________________________________________________________<br> Parent's Signature</font></div> </td> </tr> </table> <p align="center"><font face="Times New Roman" size="3"></font></p>  </div> </td> </tr><tr> <td valign="top" colspan=2 height=32 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="1130a0a3.gif"> <bR> </td> </tr></table></body>