Madeline’s Modeling & Talent Agency
Registration Form
Name__________________________ Cell Phone____________________
Work Phone___________________Home Phone_____________________
E-mail____________________Home Address________________________
Apt. #____________City__________________________State___________
Height_____________Hair Color____________Eye Color________
DressSize__________________Jacket______Blouse/Shirt_________
Pant____________Shoe Size____ Date of Birth__________________
Modeling Skills: Print_____Promo_____TV_____Radio_____Runway_____
Modeling Experience:______________________________________________
Model Agreement
I_________________________________________________________hereby give Madeline’s Modeling & Talent Agency permission to use my photos, Agency Web Site Listing and/or Promotional DVD in promotion of me as a model with Madeline’s Modeling & Talent Agency.
Signed:________________________________Date________________
(A Parent must sign if under 16)
For Office use only
Need Photos:_________Audition__________Model Training______________
Model’s Web site entry date:____________________paid___
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