Please enter the preliminary that you are providing feedback for (please copy the preliminary name from the list below):

This pageant report is prepared by:   

Date of Preliminary:

Promoter:

Promoter Address:

City: State: ZIP:

Phone:

Overall Administrative Duties: Select One Excellent Good Fair Poor
Comments:

Contestant Orientation: Select One Excellent Good Fair Poor
Comments:

Judges Orientation: Select One Excellent Good Fair Poor
Comments:

Contestant Critiques: Select One Excellent Good Fair Poor
Comments:

Appearance: Select One Excellent Good Fair Poor
Comments:

Attentiveness to Contestants: Select One Excellent Good Fair Poor
Comments:

Attitude: Select One Excellent Good Fair Poor
Comments:

Performance: Select One Excellent Good Fair Poor
Comments:

Overall Pageant Experience: Select One Excellent Good Fair Poor
Comments:
 

Please list the two representatives and their information below as each pageant is required to send two entries to the Miss Gay America Pageant.

Winner

Legal Name:

Stage Name:

Address:

City: State: ZIP:

Phone:

Email:

Birth Date:

First Alternate

Legal Name:

Stage Name:

Address:

City: State: ZIP:

Phone:

Email:

Birth Date:

Second Alternate

Legal Name:

Stage Name:

Address:

City: State: ZIP:

Phone:

Email:

Birth Date:

Third Alternate

Legal Name:

Stage Name:

Address:

City: State: ZIP:

Phone:

Email:

Birth Date:

Fourth Alternate

Legal Name:

Stage Name:

Address:

City: State: ZIP:

Phone:

Email:

Birth Date:

By my submission, I certify the above information is true and accurate.