Contestant First Name:

E-mail Address:

Phone Number:

Name of Pageant:

Pageant Date:

If you are the parent of the contestant, your name:

My preferred appointment day and time is:

Tuesday Afternoon

Wednesday Afternoon/Early Evening

Thursday Afternoon/Evening

Saturday Morning (Please note limited Saturday appointments are available.)

(Due to a busy coaching calendar, The Pageant Coach™, can not guarantee that your preferred day and time will be available at the time of your application.)

This is my first pageant competition

I've competed before

Please review my application and contact me to schedule a:

One Hour Coaching session ($150)

3 Hour Coaching Package ($450 Offered for a limited time at $360)

6 Hour Coaching Package ($900 For a limited time available at $720)

10 Hour Coaching Package ($1500 Available for a limited time at $1200)

Private One-Day Personal Workshop ($2000 For a limited time only $1500)       Available Tuesday – Friday and some Saturdays