I want to Model for the OhioGirlsvsMichiganGirls.com Girls Calendar project

Please provide the following contact information:

First Name
Last Name
Middle Initial
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
FAX
E-mail
URL

Dress size?

Eye Color:

Brown Blue Hazel green

Shoe size?

Height in inches?

Weight?                     Age

Which State would you like to represent in this "project"?
             Ohio Michigan

I am of 18 years of age

I give permission  to OhiovsMichigan.com and agents there in to publish pictures or likeness of me