Michiana Talent Model Signup Form
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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
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