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Mutya ning Magalang 2011 2x2 Picture

Entry Form

I. GENERAL INFORMATION Family Name

First

Middle

Nickname

Address: Telephone: (Home)

(Mobile)

Age:

Birth Date:

Height:

Weight: _

(Email)

Birth Place: Bust:

Citizenship:

Hips:

Dress Size:

Shoes: ____ Swimsuit:

Educational Attainment:

School:

Occupation:

Company:

Mother’s Name:

Occupation:

Father’s Name:

Occupation:

Language or Dialects Spoken: Passport No:

Place:

Date issued & Expiration

History Medical Sickness (Allergy): II. PERSONAL INFORMATION Special Talents: Any Special Facts about your Family Please list down any interesting information about you Are you under a management Contract? If yes, please list down the company’s name and the date of effectivity of the contract: Participation in Beauty Pageants (Please provide accurate details) Date:

Name of Pageant:

Awards Received:

III. INTEREST AND OTHERS Color:

Food:

Sports:

Song: Hobbies:

List the most impressive and influential of the following and state why? Book and Author: TV Program: Actor/Actress: Film: List of places you have travelled/visited/year: What is your life ambition? Who would you most like to meet and why?

Singer:


What do you think you will enjoy most during the pageant? Why would you like to win the contest? What is the most unusual thing you have ever done? Have never give birth

No criminal record or illegal offense

Yes

Yes

No

No

 In case emergency, whom do we contact? Tel. No.:  List down character references not related to you, their address, telephone numbers and email: ________________________________________________________________________________________________________

I hereby declare that in the event I shall be considered a Contestant, I shall be able to meet all the requirements, terms and conditions of the pageant vent set forth by the pageant committee. I certify to the validity of the above information and that my entry to the Mutya ning Magalang is voluntary:

_________________________ Entrant’s Signature

Endorsed By:

_________________________ Date:

________________________ Signature of Punong Barangay

Parental Consent: ________________________ _ Father (Printed Name and Signature)

________________________ Mother (Printed Name and Signature)

Note: Entry forms shall be submitted at the below listed address on or before June 24, 2011 Magalang Tourism Office 2nd floor, Main Building Municipal Compound San Nicolas I, Magalang, Pampanga Telephone: (045) 343-4444 IV. PAGEANT REQUIREMENTS     

Natural Born Female; High School Graduate. At least 18 but not more than 25 years old; with a minimum height of 5’5”. Must be at least a high school graduate; Must possess beauty of face and figure, has an outstanding personality, smart and witty; Must be of Magalang ancestry, with at least one (1) grandparent in the direct paternal or maternal line possessing Magaleña descent; Needs to submit together with this form the following to the above address:  One Colored Passport Size photo, one Colored Head shot (close-up) and one colored Full Body shot in swimsuit  Photocopy of Birth Certificate  Photocopy of High School Diploma, if available

Mutya ning Magalang 2011 Application Form  

Application Form

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