Please complete all questions on the form, if you are un-sure of any areas, leave blank and add a note to the 'Other Information'

section at the bottom, once we receive your form you will be notified by email of the next stage.

Surname Christian Name
Date of birth. Nationality
Home phone Mobile phone
       
Address Occupation
Talents Hobbies
Who's cool Who's not
Ambition Tell us about your life style
Your likes Your dislikes
Other information  
Tick to confirm the details are correct to the best of your knowledge, and you agree to the rules set out by the organisers (click here).
How would you like us to contact you.

phone   letter   email

Your email address

     

Web site donated by Specer Richardson Investments 2011 - Owner Mrs D Slater, Rugby, Warwickshire - All images remain the property of Miss Rugby UK 2002-2011.