MR AND MISS AKWA IBOM USA 2025 APPLICATION FORM

First Name

Last Name

Address

City

State

Zip Code

Phone/Mobile

Do You Agree That You Are Between The Age Of 18-28?

Yes

Date of birth

Occupation

Educational Status

Checkbox Field

Yes

If "YES", Please Specify

Passion

Hobbies

AKISAN Chapter

Name of Parent/Guardian

Have You Participated In Any Pageantry?

Yes

Upload Chapter Attestation (Any Application without Chapter Attestation will be rejected)

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Upload your full photo

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Social Media

Do you have any Social Media?

Yes

No N/A

Instagram

Twitter

Tiktok

Specific if not Listed

A Brief Bio

What project or initiative do you envision implementing if you are crowned the winner of this pageant?

I have read and agree to the Terms and Conditions and Privacy Policy on the Popup screen.

Please ensure this form is filled correctly and returned on/or before May 31st, 2025.

GOODLUCK !!!

AKISAN USA, Inc. does not discriminate on the basis of sex, age, color, gender, intellectual disability, or learning disability. AKISAN USA, Inc. does not condone acts of discrimination or harassment. Reports of discrimination or harassment should be directed to the local public authorities.

Useful links

AKWA IBOM HOUSE

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Address: 5120 Old Bill Cook Rd, Atlanta, GA 30349, United States

Akwa Ibom State Association of Nigeria, (USA) Inc. (AKISAN USA)
P. O. Box 21
Dacula, GA 30019

Mailing box

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