Blazer Media

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Model Application

Ready to get started? Fill out the following form and click "Submit."
We do NOT share your information.

Personal Information

Real Name:     
Stage Name:     
Birthdate:     
You must be 18 years old or older.
Sex:     
Ethnicity:     

Contact Information

Email Address:     
Confirm Email Address:     
Phone Number:     
AOL Messenger:     
Yahoo! Messenger:     
MSN Messenger:     
ICQ Number:     
Preferred Method of Contact:     
City:     
State:     
If outside the United States select "Not Applicable"

Physical Information

Eyes:     
Hair:       
Height:       ' 
Weight:     
Cup:      /  
Body Modifications (Piercings, Tattoos, Ect.):     

Interests and Experience

Nudity Ok?:     
Modeling Experience:     
Tell Us About Yourself:     

File Submissions

Upload a recent photo of yourself:     
Maximum file size is 20MB
Upload a second recent photo of yourself:     
Maximum file size is 20MB
Upload a third recent photo of yourself:     
Maximum file size is 20MB
Upload a forth recent photo of yourself:     
Maximum file size is 20MB
Upload a fifth recent photo of yourself:     
Maximum file size is 20MB
Upload your resume or anything else you would like us to see:
Maximum file size is 20MB