First Name *
Last Name *
Email  *
Stage Name
Age - You Must be at Least 18 *	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909
Pic Of Your Face  *
Pic, Full Body Shot If Possible
Pic
Pic
City *
State *	Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Phone
Have you Modeled Before	Yes No a few amature shots
What is your Myspace Profile
Model Mayhem or OPM Numbers
Are you willing to trave to Las Vegas for work?
What type Of Work are You Willing to do	Non-Nude Bra & Panty / Sexy Clothes Topless Implied Nudity Nude Fetish / Fantasy / Other
Height *
Weight *
Body Type  *	Slim / Slender Athletic Average Some Extra
Ethnicity	Asian Black / African decent Latino / Hispanic White / Caucasian Other
Tattos / Piercings / Scars  *	Yes No
If Yes Please Explain in detail
Any Other Information We Should Know?
Did any one refer you to us? If so who?
How Did You Find Us?
	Problems - Contact Us - Judy(at)vegastopmodels.com
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