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MISS BICOLANDIA EXECUTIVE COMMITTEE 2022 MISS BICOLANDIA BEAUTY PAGEANT THIS FORM IS NOT FOR SALE OFFICIAL APPLICATION FORM (Please fill up the form in your own handwriting and submit to the Miss Bicolandia Secretariat) I. PERSONAL INFORMATION NAME NICKNAME PEN NAME, STAGE NAME, PSUEDONYM SEX CITIZENSHIP (if naturalized, mention date of naturalization) PRESENT ADDRESS AGE DATE OF BIRTH PLACE OF BIRTH CONTACT DETAILS LANDLINE1 MOBILE1 EMAIL1 LANDLINE2 MOBILE2 EMAIL2 I can most easily be reached through: PASSPORT DETAILS Place issued Date issued Valid until Details of Foreign Passport or any Foreign Travel Document (if any): OCCUPATION a. Details of Present Occupation OCCUPATION EMPLOYMENT ADDRESS CONTACT NUMBER b. Details of Prior Occupation OCCUPATION EMPLOYMENT ADDRESS CONTACT NUMBER Applicant’s Name and Signature Date Handler’s Name and Signature Page 1 of 9 PARTICIPATION IN OTHER BEAUTY PAGEANTS BEAUTY CONTEST/ORGANIZER TITLE WON DATE EDUCATION (ELEMENTARY) PERIOD/YEAR SCHOOL/UNIVERSITY ADDRESS DEGREE/LEVEL CONTACT PERSON GRADUATED EDUCATION (SECONDARY) PERIOD/YEAR SCHOOL/UNIVERSITY ADDRESS DEGREE/LEVEL CONTACT PERSON GRADUATED EDUCATION (TERTIARY/TECHNICAL-VOCATIONAL) PERIOD/YEAR SCHOOL/UNIVERSITY ADDRESS DEGREE/LEVEL CONTACT PERSON GRADUATED EDUCATION (GRADUATE STUDIES) PERIOD/YEAR SCHOOL/UNIVERSITY ADDRESS DEGREE/LEVEL CONTACT PERSON GRADUATED LANGUAGES/DIALECTS SPOKEN: OTHER PERSONAL INFORMATION HOBBIES SPORTS ACTIVITIES TALENTS/SKILLS Applicant’s Name and Signature Date Handler’s Name and Signature Page 2 of 9 HANDLER’S INFORMATION COMPLETE NAME COMPLETE ADDRESS MOBILE NUMBER EMAIL ADDRESS FAMILY BACKGROUND Name OCCUPATION ADDRESS CONTACT NO. Father Mother Guardian (if any) If parents are separated, who has legal custody (if applicant is a minor) BODY MEASUREMENTS AND INFORMATION HAIR HEIGHT WEIGHT EYE COLOR COLOR BUST WAIST HIPS PERSONAL REFERENCES (provide at least 3 references who are not relatives) NAME ADDRESS CONTACT NOS. 1. 2. 3. REASON/S FOR APPLYING FOR THE PAGEANT: Applicant’s Name and Signature Date Handler’s Name and Signature Page 3 of 9 OTHER INTERESTING PERSONAL INFORMATION (IF ANY): II. TERMS AND CONDITIONS 1. The undersigned applicant (the “Applicant”) shall make full and honest disclosure of particulars, information, data and/or matters, as herein required, or as may hereafter be required by, or on behalf of, the Miss Bicolandia Executive Committee (the “Execom”). The Applicant hereby certifies that all particulars, information, data and/or matters indicated in this Application Form, including the representations under Paragraph 10 below, and such documents attached hereto are true and authentic, and that there are no false statements, fabrications, misrepresentations or omissions herein. Any such false statement(s), misrepresentation(s), fabrication(s), omission(s) or submission of falsified document(s) shall be sufficient ground for the Execom to reject this application, disqualify, ban and/or dethrone the Applicant, without prejudice to any other remedies the Execom may be entitled to under the premises. 2. The Applicant irrevocably grants the Execom the right to use the particulars, information, data and/or matters and representations referred to under Paragraph 1 above, as the Execom may deem fit. 3. The Applicant hereby acknowledges that the Execom shall be at liberty to publish and otherwise use any recordings made in relation to the Miss Bicolandia 2022 Beauty Pageant (the “Pageant”), including, without limitation, the information on the Pageant, the Pageant applicants, audio recordings, visual recordings, and photographs, for the promotion of the Pageant. 4. The Applicant shall not, at any time, without the prior written approval of the Execom, speak to, nor grant interviews or comments to the press, the media, vloggers, social media influencers and the like, relating to the Pageant or to any applicant or candidate thereof, including the Applicant herself. 5. If selected as an Official Candidate, the Applicant shall - 5.1 Fully agree to be represented by the Execom upon such selection as an Official Candidate up to the conclusion of the Pageant marked by the announcement of the Pageant winners, i.e., the Titleholder and the Pageant Placers, and the conclusion of the coronation night. 5.2 Compete up to the Miss Bicolandia Coronation Night and finish the Pageant until the conclusion of the said coronation night and the official events thereafter. Should the Applicant decide not to participate in the Miss Bicolandia Coronation Night, the Applicant shall notify the Execom in writing within forty-eight (48) hours from the selection of the official candidates. Otherwise, the Execom may take such action against the Applicant as shall be deemed necessary to recover the costs and monies extended to the Applicant which is not less than ten percent (10%) of the total cost of the entire Pageant up to its completion. 5.3 Attend all rehearsals and official functions. The Applicant shall not be excused, except with the prior written permission of the Execom. Applicant’s Name and Signature Date Handler’s Name and Signature Page 4 of 9 5.4 Not join in any other beauty pageant, modeling, talent searches, or any competition of similar nature, prior to the Miss Bicolandia Coronation Night, unless allowed in writing by the Execom. 5.5 Take part in any and all marketing, promotional, publicity exercises and efforts, as may be deemed necessary by the Execom. 5.6 At all times comply strictly with the Pageant specifications and/or requirements, whether oral or in writing, as to appearance, physical characteristics, skills, attire, accessories, conduct, and behavior. The Applicant understands that failure to comply with any undertaking under Paragraph 5 hereof may result to the outright disqualification of this application, disqualification from the Pageant and from joining any future Miss Bicolandia pageant, and the forfeiture of any and all awards and prizes, subject to the sole discretion of the Execom. 6. If selected as a Titleholder or a Pageant Placer, the Applicant shall – 6.1 Attend all official functions as requested by the Execom. 6.2 Perform all duties and responsibilities appurtenant to the title or award won. 6.3 Conduct oneself with utmost integrity, grace and self-respect. 6.4 Comply with such other duties and responsibilities as may be reasonably required by the Execom. 7. The Applicant and/or the Handler shall not, at any time, post, comment, publish, spread, share and/or support any false, baseless, defamatory or malicious claims, statements, comments, posts, and the like, against the Execom, the Pageant judges, the Pageant sponsors, and/or about the conduct or the result of the Pageant, at any stage thereof, nor grant any interview, in any platform, that contains false, baseless, defamatory or malicious accusation(s), implication(s), statement(s), etc. as against the Execom, the Pageant judges, the Pageant sponsors, and/or about the conduct or the result of the Pageant, at any stage thereof. The Applicant and/or the Handler hereby fully agree to submit to due process to be conducted by the Execom for any such incident referred to in the immediately preceding paragraph. Failure to substantiate and prove any such claims, and/or failure to appear at the conference or dialogue called for that purpose, may, at the sole discretion of the Execom, result to the perpetual disqualification of the Applicant and/or the Handler in future Miss Bicolandia pageants and/or the forfeiture of any title and/or prizes received through the Pageant, without prejudice to other legal remedies available to the Execom. 8. Both the Applicant and/or the Handler shall not resort to any unbecoming and/or scandalous conduct or behavior, during and after the Pageant, that could bring disrepute, embarrassment, negative publicity or shame to the Pageant and/or the Execom. 9. The Execom reserves the right to reject, disqualify, ban or dethrone any Applicant, Candidate, Pageant Placer and/or Titleholder on the ground of undesirable conduct and/or appearance. The Execom likewise reserves the right to disqualify and/or ban a handler on the ground of undesirable or disrespectful conduct. Applicant’s Name and Signature Date Handler’s Name and Signature Page 5 of 9 10. The Applicant further certifies that: 10.1 She is neither married, nor has she ever been married, has never sought the annulment of her marriage or the declaration of nullity thereof. 10.2 She has never been, nor is presently pregnant. She has neither given birth to child nor is a parent. 10.3 She is in good mental, psychological and physical health and is able to perform and participate in the Pageant and all the rehearsals and official functions appurtenant thereto. 10.4 She has never been sick or has been hospitalized for cancer, epilepsy, HIV, AIDS, heart ailment, a disease involving the gastrointestinal system or any other disease that could impair her mental, psychological and/or physical health or condition. 10.5 She is neither suffering from, nor has she ever been under prolonged medication for any physical, neurological, psychological or psychiatric condition, including eating and/or personality disorder(s) which could impair her ability to act as an Applicant, Candidate, and/or Pageant Placer or Titleholder. 10.6 She is of good moral character. 10.7 She has not been charged or convicted in any court of law in any country. 10.8 She is not a fugitive nor is she wanted by any law enforcement agency. 10.9 She is not under probation nor is a former probationer. 10.10 She has never participated in any bold or burlesque shows, plays, movies, publications or activities, or such show, play, movie, publication or activity, which, in the sole opinion and discretion of the Execom, is inconsistent with her application for the Pageant, run counter against the social and moral principles upon which the Pageant is founded upon, and/or bring disrepute or embarrassment to the Pageant or any of its sponsors. 10.11 She has not engaged in prostitution or any such act which can be deemed as similar or related thereto. 10.12 She is not a party to any contract which in any manner prohibits her from joining the Pageant or from performing her duties and responsibilities as an Applicant, Candidate, Pageant Placer or Titleholder. 10.13 She is not a party to any contract which, in the sole opinion and discretion of the Execom, could cause her disqualification as an Applicant, Candidate, Pageant Placer or Titleholder. 10.14 She was born with the anatomy of a female and that she has not consented to and/or undergone any surgical, medical and/or cosmetic procedure to transform her into a biological female. The Applicant hereby agrees and accepts to be bound by these Terms & Conditions. The Handler likewise agrees and accepts to be bound by the applicable Terms & Conditions herein. Applicant’s Name and Signature Date Handler’s Name and Signature III. DOCUMENTS SUBMITTED 1. Attached to this application are the photocopies of the following documents, the original of which I am presenting to the Screening Committee and/or Secretariat for comparison and verification: BICOLANA BY BLOOD (either of her parent or both Parents are Bicolanos) even if at present applicant-candidate is not a resident of Bicol region q Duly Accomplished Miss Bicolandia Application Form q Official written endorsement from the Municipal/City Mayor q Certificate of residency and good moral character from the Punong Barangay q Certificate of employment, if employed q Registrar’s/School head’s certification of educational level/course completed/presently enrolled q Medical Certificate of physical/mental fitness issued by a practicing licensed physician q Vaccination Card Page 6 of 9 q NSO or Civil Registry Office issued Birth Certificate or Passport (original copy or certified true copy), and q Certified true copy of birth certificate of mother or father (original copy or certified true copy) BICOLANA BY BIRTH (both parents not Bicolanos but applicant-candidate was born in Bicol Region) even if at present she is not a resident of Bicol Region) q Duly Accomplished Miss Bicolandia Application Form q Official written endorsement from the Municipal/City Mayor q Certificate of residency and good moral character from the Punong Barangay q Certificate of employment, if employed q Registrar’s/School head’s certification of educational level/course completed/presently enrolled q Medical Certificate of physical/mental fitness issued by a practicing licensed physician q Vaccination Card q Certified true copy of birth certificate of mother or father (original copy or certified true copy) 3 CONSECUTIVE YEARS RESIDENCE (not by blood or by birth) q Duly Accomplished Miss Bicolandia Application Form q Certified true copy of birth certificate or Passport (if photocopy, bring original) q Certificate of residency and good moral character issued by the Barangay Captain of the place of present residence indicating the inclusive dates and period (duration) of residency, if available q If employed, certificate of employment q Registrar’s/School head’s certification of educational level/course completed/presently enrolled; q Medical Certificate of physical/mental fitness issued by a practicing licensed physician q Vaccination Card 2. In addition to the documents listed above, I also submit two (2) photographs, one close-up and one full body shot TO BE FILLED UP BY SECRETARIAT Date Received Received by CLOSE UP PHOTO FULL BODY SHOT 3. I hereby authorize the Execom and its committees to verify the truth of all my assertions herein and the genuineness/validity of all the documents I have submitted, thereby waving for these purposes the provisions of all laws, rules, and regulations, local or foreign, relating to the privacy or confidentiality of the matters hereunder. Applicant’s Name and Signature Date Handler’s Name and Signature Page 7 of 9 4. I warrant that the documents I have submitted are public documents in my possession or which came into my possession legally and/or are public documents attested to by the officer/s having the legal custody of the records, and that, where applicable, the entries therein were made in the regular performance of an official duty, and that I will hold the Execom and its committees free and harmless from any breach of this Warranty. IV. UNDERSTANDING OF CONDITIONS 1. I am aware that the Execom, at its sole discretion, may require me to submit additional and sufficient proof of age, residency, citizenship, health and other documentation/information regarding my qualifications. Should I be required to do so, I undertake to provide the Execom with such requested documentation information, and failing to comply within the period to submit, as determined by the Execom, I understand that my application shall not be considered complete and submitted. 2. I understand that I must pass the screening and meet all the requirements of the Execom before I can qualify as a candidate of the Pageant. I further understand that the basic requirements relate to information obtained from me as contained in this Application Form. 3. In considering my application to be a candidate of the Pageant, I also understand that personal achievements, intelligence, beauty, physical fitness, personal style and charisma, faithful compliance with the terms, conditions, guidelines, rules and regulations of past Miss Bicolandia pageant(s) of which I was a part of, among other criteria, shall also be considered. I agree that all issues as to my eligibility as an applicant shall be determined solely by the Execom and that I shall abide by its determination, which shall be final and non-appealable. 4. In filling out and signing this Application Form, I further understand that the Execom is under no obligation to accept me as a candidate. My acceptance as an official candidate shall commence only when I am formally and specifically notified thereof. 5. If I am chosen as an Official Candidate, this Application Form shall be considered part and parcel of the Official Entry Form/Contract which I may be required to sign. 6. If I am chosen as a Titleholder or Pageant Placer, this Application Form shall be considered part and parcel of any subsequent contract which I may be required to sign. 7. I understand that in signing this Application Form, I have accepted the sole discretion of the Execom to accept or reject me as a candidate of the Pageant and that the decision of the Execom on this application is final and non-appealable. 8. I certify that I have read this Application Form carefully, that I have understood the same, and that no promises or representations were made to induce me to sign this Application Form. 9. Finally, I certify that I have read and fully understood the pageant guidelines, terms and conditions, and their implications. I likewise agree that non-compliance with any stipulation, guideline, term or condition herein could automatically merit subsequent penalties and/or disqualification. By affirming my signature, I hereby agree with the stipulations, guidelines, terms and conditions stated herein and their implications on me and/or the party(ies) I represent. Applicant’s Name and Signature Date Handler’s Name and Signature Page 8 of 9 IF APPLICANT IS MINOR Signature(s) over printed name(s) of both parent(s) (custodial parent if separated or if parent is solo parent) or of the legal guardian NAMES SIGNATURE DATE FATHER MOTHER GUARDIAN NOTE: Signatories on this page must also sign each and every page of this Application Form below the signature box. Page 9 of 9