Michiana Talent Model Signup Form

Please fill out the application as completely as you can. Applications with incomplete or inaccurate information are discarded. If you don't have an email address, you can obtain a free email address at MichianaWeb.Com (Your personal details are kept confidential) Click here if you care to review our Privacy Policy. Click here to read frequent questions and answers about our modeling program. (opens in new window) Personal Details Check here if you have applied with us in the past so we can avoid duplicate records.                   E-mail Address:   Managers E-Mail: (if any):   First Name:   Last Name:             Alias:   Street Address:   Suite/Apt:   City:   State/Province:   Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Canada Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory ZIP Code:   Home Phone:      Cellular Phone:      Personal Statistics Age:   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 Date of Birth:   DD/MM/YY Gender:   Female Male Chest/Bust (inches):   24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70      Cup  N/A A B C D DD DDD E EE EEE F FF FFF G GG GGG Waist (inches):   10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70   Hips (inches):   10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70   Height (inches):   12 13 14 15 16 17 18 19 20 21 22 23 24 (2 feet) 25 26 27 28 29 30 31 32 33 34 35 36 (3 Feet) 37 38 39 40 41 42 43 44 45 46 47 48 (4 feet) 49 50 51 52 53 54 55 56 57 58 59 60 (5 feet) 61 62 63 64 65 66 67 68 69 70 71 72 (6 feet) 73 74 75 76 77 78 79 80 81 82 83 84 (7 feet) 85 86 87 88 89 90   Weight (lbs):   10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 105 110 115 120 125 130 135 140 145 150 155 160 165 170 175 180 185 190 195 200 205 210 215 220 225 230 235 240 245 250 255 260 265 270 275 280 285 290 295 300 305 310 315 320 Hair Color:   Black Brown Blonde Red Grey Other Hair Length:   Very Short Medium Short Shoulder Length Long Very Long Bald Eye Color:   Black Blue Brown Green Hazel Other Skin Color:   White Black Tanned Olive Other Shoe Size (inches):   2 2.5 3 3.5 4 4.5 5 5.5 6 6.5 7 7.5 8 8.5 9 9.5 10 10.5 11 11.5 12 12.5 13 13.5 14 Dress Size:   0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Ethnicity: White or Caucasian Latin or Hispanic Oriental or East Asian Black or Afro-origin Polynesian or Pacific Islander American Indian or Native American Middle Eastern or Indian Other Experience Level: None Amateur Professional Preferred Assignments  Sport Runway Print Work Fashion Hair Casual Parts Modeling Swimsuits Fine Art Art Subject Glamour Lingerie Adults 18 and over. See Through or Partial Nudes Artistic Nude Poses Erotic Nude Adult Performer (These are optional, see our FAQ's) Security code Security Image Type Security code When done, please press...