MISS LUZERNE COUNTY S OUTSTANDING TEEN / MISS NORTHEASTERN PA S OUTSTANDING TEEN / MISS WILKES-BARRE/SCRANTON S OUTSTANDING TEEN SCHOLARSHIP PAGEANT

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1 2018 NEPA SCHOLARSHIP ASSOCIATION, INC. MISS LUZERNE COUNTY S OUTSTANDING TEEN / MISS NORTHEASTERN PA S OUTSTANDING TEEN / MISS WILKES-BARRE/SCRANTON S OUTSTANDING TEEN SCHOLARSHIP PAGEANT Dear Prospective Teen Contestant: NEPA S OFFICIAL PRELIMINARY TO MISS PA OUTSTANDING TEEN, AND THE OFFICIAL MISS AMERICA TEEN PROGRAM We are pleased that you are considering entering the 2018 Miss Luzerne County s Outstanding Teen, Miss Northeastern PA s Outstanding Teen, and Miss Wilkes-Barre/Scranton s Outstanding Teen Scholarship Pageant, to be held Sunday, October 29, 2017 at Dallas High, School Dallas, PA. This is the official Miss America Scholarship Pageant s sister Teen Program. This program is for young ladies years of age. Please note that if you are 17 and a senior you are not eligible for the Teen Program but are eligible for the Miss Program. For all the details on eligibility requirements, please visit the Teen section of our website. This is a scholarship competition, with scoring as follows: Private Interview 35% Evening Wear & On-Stage Question 20% Talent 35% Lifestyle and Fitness -10% Fill out and mail the 2018 Teen Application form along with a copy of your birth certificate, proof of residency (state ID card or an official document that shows your address), a headshot photo (does not have to be the one you want used in the program) (These items are not returnable). Once we receive the above information, you will receive an confirmation from us that your items above have been received, and you are guaranteed a spot in the line-up. We will mail to you the local pageant agreement form and all other forms such as fact sheet, critical issue essay, talent form (include a copy of the CD you will use in your on stage talent presentation) and accident /medical form. Note that all the above items should be received preferably one month in advance of the event date. Official deadlines will be posted on the nepapageant.com website. 588 KASKO ROAD, SHAVERTOWN, PA INFO@NEPAPAGEANT.COM

2 You may also check the Northeastern PA Pageant Association website at There is an entry fee of $100, and it is approved and supported by the Miss Outstanding Teen Program. The NEPA events are produced by the NEPA Scholarship Pageant Association, Inc., a PA state not-for-profit organization. Once you have completed your forms, please mail them along with your entrance fee to: NEPA Scholarship Pageant Association, Inc. 588 Kasko Road Shavertown, PA Any questions should be ed to: info@nepapageant.com The winner of Miss Luzerne County s Outstanding Teen, Miss Northeastern PA s Outstanding Teen and Miss Wilkes- Barre/Scranton Outstanding Teen will compete in the Miss PA s Outstanding Teen finals in June, Her state entrance fees will be underwritten by the NEPA Scholarship Pageant Association, along with competition needs from its kind sponsors. If you would like to enter, but are new to all this, please note that the NEPA event will hold rehearsals on Sunday morning October 29, We will rehearse opening number, on-stage walking/modeling, plus help with hair and makeup. We will hold a short orientation Saturday evening, October 28, 2017 (Time TBA). Should you have questions concerning the scholarship pageant, how to enter, or about the program itself please feel free to info@nepapageant.com Remember to get your application in as quickly as possible to ensure your spot in the NEPA Pageant! Sincerely, Dawn Cinti, Teen Director Charles Kasko, Executive Director NEPA Scholarship Pageant Association, Inc. 588 KASKO ROAD, SHAVERTOWN, PA INFO@NEPAPAGEANT.COM

3 NEPA SCHOLARSHIP ASSOCIATION, INC APPLICATION FORM MISS LUZERNE COUNTY S OUTSTANDING TEEN / MISS NORTHEASTERN PA S OUTSTANDING TEEN / MISS WILKES-BARRE/SCRANTON S OUTSTANDING TEEN SCHOLARSHIP PAGEANT Please complete and mail immediately to hold your spot! Full Name Age Date of Birth Home Address City, State & Zip Phone # Addresses STATISTICS Hair Color Eye Color Height EDUCATION High School Year Graduated EMPLOYMENT Employer s Name & Address Title Date of Hire TALENT PRESENTATION Please indicate type of talent and, if known, song title and type of musical background NEPA Scholarship Pageant 2018 Application, Page 1 of 2

4 SPECIAL TRAINING IN TALENT Please list any training you have had in music, drama, dancing, voice, art, etc INTERESTING FACTS Please list any interesting facts for publicity PARENTS Please list the first and last names and hometowns of your parents Are you a citizen of the United States? Yes No Are you a female and born a female? Yes No Your Social Security Number Signature Parent or Guardian s Signature Parent or Guardian s All data must be factual. The failure to provide factual information may result in your disqualification from the pageant. You will be required to furnish a photo copy of your birth certificate and a photo ID with date of birth and residency clearly shown. These copies may be returned with this application or at the latest, one month prior to the pageant. Mail application, $100 Entry Fee, photo ID with residency or birth certificate copy as soon as possible to hold your spot to: NEPA Scholarship Pageants, 588 Kasko Road, Shavertown PA If possible, if you are new to this program, please submit a recent photograph. You may submit another photo for the Program Book, if you wish. This application will NOT go to the judges. This form need not be typewritten. It may be completed in ink. Include the FACT SHEET and CRITICAL ESSAY with your application if they are ready. These two forms must be typewritten to specifications. TO BE ACCEPTED INTO THE PAGEANT, THOSE APPLICATIONS FROM THE CONTESTANTS DATED EARLIEST WILL BE ACCEPTED AND THOSE FROM CONTESTANTS DATED LATER WILL BE PLACED ON A WAITING LIST if far too many applications are received. Mail your application first to hold a spot, but then follow with THE FACT SHEET AND CRITICAL ISSUE ESSAY to be considered a contestant. You will hear from us if too many have applied and you are on a wait list. ALL ADDITIONAL PAPERWORK AND VERIFICATIONS MUST BE RECEIVED IN A TIMELY MANNER. NEPA Scholarship Pageant 2018 Application, Page 2 of KASKO ROAD, SHAVERTOWN, PA INFO@NEPAPAGEANT.COM

5 2017 NEPA SCHOLARSHIP PLEASE REMEMBER ASSOCIATION, INC. MISS LUZERNE COUNTY S OUTSTANDING TEEN / MISS NORTHEASTERN PA S OUTSTANDING TEEN/ MISS WILKES-BARRE/SCRANTON S OUTSTANDING TEEN TYPING THE CRITICAL ISSUE ESSAY INSTRUCTIONS This ONE (1) page, single-spaced document combined with the Contestant s Resume, will comprise your entire application for this job. The judge s will receive exactly what is submitted. Any items submitted that do not fit the established criteria will be returned for correction only once. Any items which do not meet the criteria or are submitted after the deadline will not be given to the judges. The contestant may explain the lack of judging materials during her interview, if she so chooses. The resume should include an explanation of what your chosen platform is, how you will promote it, and why it is important for the local pageant to embrace this platform. 1. Go to the word processing program of your computer. 2. Start a new document. 3. Set the margins for 1 on all four sides. The font style may not be any smaller than 10 and no larger than 12 point type using the Times New Roman font style only. 4. With the justification set to the far left, type Name: in bold. Following the colon (:), hit the space bar twice. Then, type your name. 5. Double space down. Set your justification to center. Then type in Bold and underline the title of your Platform. 6. Double space down. Write what you feel is critical for the judge s to know about your platform and why it is necessary for you to have the job of Miss Luzerne County s Outstanding Teen, Miss Northeastern PA s Outstanding Teen or Miss Wilkes-Barre/Scranton s Outstanding Teen to promote this issue. What you write will be what the judges know about your platform, your role in successfully dealing with this issue, and how the role of Miss Luzerne County s Outstanding Teen, Miss Northeastern PA s Outstanding Teen or Miss Wilkes-Barre/Scranton s Outstanding Teen may play in your plan. 7. The essay may include some of the following items (this is not meant as an exhaustive list): A clear definition of the platform and the specific issues you wish to address A plan of how you have or will create awareness of the platform The way in which you have or will change attitudes regarding this issue The way in which your platform issue will move the NEPA Scholarship Pageant forward. Your media plans Your marketing strategy How you propose to fund your ideas/plans Any significant accomplishments you have made in regard to your issue 8. At the bottom of the page you MUST set the justification to the right. Type a line of 26 spaces. Below that line, you must type Signature/Date. Once you have printed the document, you must sign and date this document.

6 Miss Local s or State s Outstanding Teen Organization - Instructions for Preparing the Judges Resume Remember this is your opportunity to demonstrate to the judges why they should consider you for the position of Miss Local s or State s Outstanding Teen. You may list as many or as few items under each category as you desire. This one page, combined with your Platform Statement, and your Competition Contestant Contract will comprise your entire application for the responsibility of becoming Miss Local s or State s Outstanding Teen. The judges will receive your resume exactly as it is submitted. Do not put your age on the Resume! 1. Set margins for 1 on all four sides. The font style may not be any smaller than 10 and no larger than 12 point type, using the Times Roman font style. 2. With the justification set for left, type Name: in bold. Following the colon (:), press the tab key five times. Then, type your name as you wish the judges to know it. (If your name is Mary Deborah Smith and you want to be known as Deborah Smith, please type Deborah Smith ). 3. Double space down. Type Title: in bold. Following the colon (:), press the tab key five times. Then, type the Local title for which you are competing or the Local title that you hold for state pageants. 4. Double space down. Type Hometown: in bold. Following the colon (:), press the tab key four times. Then type your hometown including the city and the state. 5. Double space down. Type Education: in bold. Following the colon (:), press the tab key four times. Then type your most recent school first. List in order with the most recent, all schools attended (high school, middle school, elementary school, Pre-K, etc.). 6. Double space down. Type Platform Issue: in bold. Following the colon (:), press the tab key three times. Type the title of your platform, making sure it lines up with the other information above it. Do not type anything other than the platform title. 7. Double space down. Type Scholastic/Career Ambition: in bold. Following the colon (:), press the tab key one time. Then type the type of degree/education you would ultimately like to achieve, making sure it lines up with the other information above it. Beneath that, list your career ambition. 8. Double space down. Type Talent: in bold. Following the colon (:), press the tab key four times. Type the type of talent you will perform and specific selection, making sure it lines up with the information above it. (e.g., Pop Vocal - Rolling in the Deep, Tap Dance - Moves Like Jagger, etc.) 9. Double space down. Type Scholastic Honors: in bold. Following the colon (:), press the space bar twice. Type your scholastic honors. Each item should be separated by a semi-colon (;). 10. Double space down. Type Leadership Roles: in bold. Following the colon (:), press the space bar twice. Each item should be separated by a semi-colon (;). 11. Double space down. Type Accomplishments: in bold. Following the colon (:), press the space bar twice. Each item should be separated by a semi-colon (;). Do not include any previous local titles held in the Miss America s Outstanding Teen Program or placement!

7 Miss Local s or State s Outstanding Teen Organization - Instructions for Preparing the Judges Resume 12. Double space down. Type Interesting Facts: in bold. Following the colon (:), press the space bar twice. Each item should be separated by a semi-colon (;). Do not include any previous local titles held in the Miss America s Outstanding Teen Program or placement! 13. Double space down. Type Marketing Plan: in bold. Following the colon (:), press the space bar twice. In sentence form, explain how you would market the Miss Local s or Miss State s Outstanding Teen brand. Please include any relevant experience you have which may uniquely qualify you to serve in this position. Please be aware that a portion of the Miss Local s or Miss State s Outstanding Teen responsibilities includes marketing the Miss Local s or Miss State s Outstanding Teen program to potential sponsors, educational institutions, and organizations. 14. Double space down. Type Legacy: in bold. Following the colon (:), press the space bar twice. This should be typed in sentence form. Please write what your legacy, as Miss Local s or State s Outstanding Teen will be. This statement should answer the question, A year after giving up your title as Miss Local s or State s Outstanding Teen, what will people remember about your year of service? 15. Double space down. Type Why I should be Miss Local s or State s Outstanding Teen 20 : in bold. Following the colon (:), press the space bar twice. This should be typed in sentence form. Explain to the judging panel why you should be selected Miss Local s or State s Outstanding Teen and, more importantly, why you should be selected Miss Local s or State s Outstanding Teen this year. Important Information Regarding the Contestant s Judges Resume Please remember that the entire form MUST FIT ON ONE PAGE using the Times Roman font style. You must leave a 1 margin on all four side of the page. Use your best judgment on what is most important for the judges to know about you. Use your space wisely. Please review the example of what the resume format look like. Any variations from this format will be returned to you and will not be accepted. Your materials will not be retyped. The judges will receive your original work. CHECK SPELLING AND GRAMMAR!! This resume, your platform statement, and possibly a local/state pageant program book will be the only documents the judges will receive about you. By submitting these forms to your local/state teen organization, you certify that everything on your forms is true and accurate. If it is proven that any information on these forms is not true, correct, and factual, you risk losing your title. Some spacing issues may arise. Simply follow the example provided. Depending upon the set up of your document, you may need to press the tab key fewer or more times than indicated above). Do not attempt to change margins, font, size options, or deviate from the requested criteria as set forth in this document. Use plain white paper for the document. Do not use paper with logos, crowns, names, decorations, or other embellishments. It will not be accepted if it is printed on anything other than plain white 8 ½ X 11 paper.

8 Name: Title: Hometown: Education: (Sample: Miss Local s or State s Outstanding Teen Contestant Resume) Deborah Smith Miss River Valley s Outstanding Teen River Valley, AnyState River Valley Senior High School River Valley Junior High School River Valley Elementary School Platform Issue: Celebrating Inclusivity Scholastic/Career Ambition: To obtain a Juris Doctorate To become an Attorney specializing in entertainment law Talent: Pop Vocal- Rolling in the Deep Scholastic Honors: Honor Roll all report card periods; taking 3 Advanced Placement classes; National Honor Society; Perfect Attendance Award; French Award; Eleanor Roosevelt Cultural Diversity Award Leadership Roles: Organized a teen volunteer group to entertain at a local nursing home; Secretary of Nostalgia Rotary Interact Club; Junior Varsity Cheerleading Captain ; Lector and Song Leader at my church; elected state senator at State Girls State Leadership Conference Accomplishments: Rotary Student of the Year; Hugh O'Brian Youth Leadership Ambassador for my school; Fresh Face Agent Award at Odyssey Dance Competition; Placed at Nostalgia Talent Show 3 years; played Dorothy in my dance studio's production of "Hip Hop Oz Interesting Facts: I teach dance to 5-13 year olds; danced with the Disney characters in the ABC television special Minnie's Magical Gathering ; modeled in the Frankie Girl Dance Costume Catalogue for the last three years; our family operates a dance studio in our home; I collect frogs of all types and shapes. Ribbit I love it. I am the only girl with red hair of all my cousins, and I ran up the steps at our city s public library like Rocky Balboa did in the movie! Marketing Plan: The best way to convince people to become involved in an organization is to provide them with evidence that the organization is successful in achieving its goals. The Miss AnyState s Outstanding Teen Program was created to give teens an avenue to develop their speaking skills and a forum to present their talents and viewpoints. As Miss River Valley s Outstanding Teen 2013, I would market the organization by making appearances and speaking at schools to demonstrate how the experience of being involved with the Miss America s Outstanding Teen Organization can help shape young women to become well-spoken, confident, and active in their communities. Legacy: I want to be known as the River Valley s Outstanding Teen who changed the way that people perceive teenagers. Although teens do not always portray themselves in the proper light, I want the River Valley Area, the State of AnyState, my peers, and the Miss AnyState s Outstanding Teen Organization to reflect on my year of service as a River Valley s Outstanding Teen who proved that teenagers can make a huge difference in every community. Why I should be Miss River Valley s Outstanding Teen 20 : I would be a good choice for River Valley s Outstanding Teen because I possess the speaking skills, talent, confidence and poise that it takes to be a local titleholder. Also, I would love to have the opportunity to utilize the title of Miss River Valley s Outstanding Teen to promote my platform of Celebrating Inclusivity throughout the River Valley and the state.

9 2018 NEPA SCHOLARSHIP ASSOCIATION, INC. MISS LUZERNE COUNTY S OUTSTANDING TEEN / MISS NORTHEASTERN PA S OUTSTANDING TEEN / MISS WILKES-BARRE/SCRANTON S OUTSTANDING TEEN TEEN TALENT REGISTRATION FORM (ALL talent presentations must be timed at 90 seconds or less) FULL NAME TYPE OF TALENT: Singing, dancing, instrumental etc. MUSIC FULL TITLE OF MUSIC: TIMED AT: COMPOSER: PUBLISHER: WILL YOU USE A CUSTOM CD?: OR A COMMERCIAL CD?: *TWO Copies required, one must be mailed with talent form one month prior to event. READING, MONOLOGUE ETC. FULL TITLE PLAY, BOOK OR WRITING: COPYRIGHTED? AUTHOR: PUBLISHER: PROPS I WILL BRING THE FOLLOWING PROPS WHICH I WILL USE IN MY ACT: MICROPHONE REQUESTS: WIRELESS HANDHELD (IF AVAILABLE): OR MICROPHONE ON A STAND: SUGGESTED TALENT INTRODUCTION: *If you plan to perform Broadway show music in character you will have to obtain your own clearance with that show s producer. These clearances are extremely difficult, often impossible to get; therefore we strongly advise against their use. No talent will be performed on our stage that does not have the proper clearances.

10 Accident/Medical Release Form NEPA Scholarship Pageant Association, Inc. ALL OF OUR PAGEANT STAFF WILL BE TAKING EVERY PRECAUTION TO PREVENT IT, BUT THE POSSIBILITY EXISTS IN ANY COMPETITION OR ACTIVITY THAT AN ACCIDENT REQUIRING MEDICAL ATTENTION COULD OCCUR. THEREFORE, THE FOLLOWING IS TO BE SIGNED BY EACH CONTESTANT AND/OR PARENT. I/We will be responsible for all medical expenses for treatment (for the full year, if you are selected as the representative) required (but not limited to) any accident resulting from competing in all events leading up to and including the NEPA Scholarship Pageant Competition. I also grant permission to be transported to the nearest hospital should medical attention be necessary. I/we do hereby agree to indemnify and hold harmless, release and discharge the NEPA Scholarship Pageant Association, Inc. its agents, servants, volunteers, from any and all claims for personal injuries or property damage occurring to or sustained by the contestant while participating in pageant activities or in the act of being transported to and from said activity and including any and all consequential damage claims which I/we may be entitled to without regard to the negligence of the parties. I agree to follow the rules and regulations set by the NEPA Scholarship Pageant Association, Inc. representatives whether written or verbal. This agreement has been entered into freely, voluntarily and after a full opportunity for review by the undersigned. Contestant s Signature Date Parent/Guardian Signature Date MEDICAL RELEASE INFORMATION Parent/Guardian phone # Physician to be called in case of emergency Physician s Address: Physician s Phone # Medical information that may affect activities: (special dietary concerns, medications, conditions, etc.) In my absence should the need arise while she is participating in programs of the NEPA Scholarship Pageant Association, Inc., I hereby authorize, consent and direct the NEPA Scholarship Pageant Association, Inc., its directors and officers and any physician, hospital or other health care provider selected by the Organization to take such action as is necessary in the circumstances to provide emergency care and related treatment of the above named. I hereby designate the NEPA Scholarship Pageant Association, Inc., its directors and officers my authorized agent for the signing of consent forms required by such health care providers in connection with such health care. Health Insurance ID number Group # Plan # Name of health care insurance provider: DATE Signature of Parent/Guardian DATE Signature of Contestant 588 Kasko Road, Shavertown PA 18708: info@nepapageant.com

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