Once you have typed in all information, please PRINT OUT this completed form and MAIL IT along with your entry photo
Mail to: Photography by Don Stachowiak, 6525 Bricktown Ci.,Glen Burnie, MD 21061
Name Street address Address (cont.) City State/Province Zip/Postal code Country Home Phone
Date of birth Sex Male Female Height Weight Hair color Blonde Brown Black Red Gray White Eye color Blue Brown Black Green Gray Violet
Tell us something about yourself! Are you an actor, singer, dancer, or model? Any past experience? Let us know!
Signature (If under 18, parent or guardian must sign) ________________________________
Signature (If under 18, parent or guardian must sign)
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