Pixelette Senior Model Application

Pixelette Senior Model Application
Our senior model program is fun and rewarding! Get a FREE Session from Pixelette plus other rewards just for telling your friends about us.
If you are interested in being one of Pixelette's Senior Models, please fill out the form below. We can only accept a limited number of models per year, so not everyone who applies can be accepted. If you are selected for the program, we will send you an email with all the details. Parent or guardian permission is required to participate in the program.

In order to be eligible for our senior model program you must be a current junior graduating in 2012 and you must live within 40 miles of the Metro Atlanta Area. You must be willing to travel to our studio for your photo shoot and be available to do your free photo shoot before May 1st, 2011.
Important :

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Model Program Details
Contact Information
Full Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Other Information
What school do you attend?
What year do you graduate high school?
Why do you think you would be a great representative?
Extra Curricular Activities (Include offices held, clubs, sports and organizations)
How did you hear about Pixelette?
Please upload a recent photo of yourself

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