Monarch Candidate Form

Thank you for your interest in being a candidate for The Imperial Court of Minnesota’s Reign 30.

Please fill out the form below or download the candidate form here and submit it electronically to candidate@impcourtmn.org

Upon submission, you will be directed to a payment screen to pay the $100 Application Fee. If submitting form separately, Payment and Form must be submitted before November 14th, 2021 to be considered for candidacy. Payment may be submitted under the donation tab on our website. Please include a note that the payment is for Reign 30 Monarch Candidacy.

Monarch Candidacy Electronic Form

Position of Candidacy: Position of Candidacy: Emperor Empress Emprex

Name

Stage Name

Street Address

City

State

Zip Code

Email Address

Phone

Are you a resident of the State of Minnesota? Are you a resident of the State of Minnesota? Yes No

Will you be 21 or older at the time of election/elevation? Will you be 21 or older at the time of election/elevation? Yes No

Are you currently a paid member "In Good Standing?" Are you currently a paid member "In Good Standing?" Yes No

Have you hosted an Official ICOM Fundraiser during the current Reign? Have you hosted an Official ICOM Fundraiser during the current Reign? Yes No

If Yes, please give Name/Date of Fundraiser

New Field New Field By clicking checkbox, I certify that all answers are correct and I have not checked "no" to any of the above questions, thereby disqualifying me from candidacy.

Signature: Full Name entered here constitutes an e-signature

3 + 5 =

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