8/11/2019 Msqc Application Form

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Name: Landline Mobile

Address:

Birthplace: Birthdate: Age: Citizenship:

Occupation: Employer:

Years of residence in Quezon City: E-mail Address:

Fathers Name: Occupation:

Mothers Name: Occupation:

Guardian: Parents / Guardians Contact Number:

Parents / Guardians Address:

Schools Attended:

Educational Attainment: Languages / Dialects spoken:

Vital Statistics: Height: Weight: Bust: Waist: Hips:

Hair Color: Eye Color: Special hobbies/Talents:

Have you ever participated in a beauty contest? If so, name of contest: When?

Have you won any title? If so, please state:

Are you under any endorsement / management contract? Name of Agent:

List down Contracts you are presently committed to and their expiration dates: Agents Contact Number:

Agents Address

Fax :

E-mail:

Three (3) personal references who are non-relatives Name Address Telephone No.

Why do you wish to join the Ms. Quezon City Diamond Jubilee?

Can you add other information about yourself?

I HEREWITH ATTEST:

1. That I have never been married, never been pregnant, and am in good health and of good moral character.

2. That all of the aforementioned are true and correct and am willing to submit satisfactory proofs of same including my age and

citizenship and educational attainment.

I also understand that I have to pass the screening and meet all the requirements of Ms. Quezon City Diamond Jubilee before I can

qualify as an official candidate and that any false misrepresentation I have made herewith is sufficient ground for my disqualification

from the contest.

Kindly submit the filled-up application form on or before June 30, 2014 at VPF Creative Productions,Unit 207, PM Building, #24 Matalino St., Bgy. Central, Quezon City Tel. # 509-1620 or 504-7945

NOTE: THIS APPLICATION FORM SHOULD BE ACCOMPANIED BY

YOUR BIRTH CERTIFICATE, VALID PROOF OF EDUCATIONAL

ATTAINMENT, CERTIFICATE OF RESIDENCY, MEDICAL

CERTIFICATE AND CERTIFICATE OF GOOD MORAL

CHARACTER, 1 CLOSE UP PASSPORT PHOTO AND 1 WHOLE

BODY 5R COLORED PICTURE.

Yes No

Yes No

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ADDITIONAL INFORMATION

MSQCDJ No.____________

Applicants Signature

Parent / Guardians Signature

Conforme:

Date Submitted:

APPLICATION FORMPlease fill up in your own handwriting