OFFICIAL ENTRY FORM

Medium: Pastel on Board Paper Acrylic on Canvass

Name: _______________________________________________________________________ Surname First Name MI

Complete Residential Address: ___________________________________________________

____________________________________________________________________________

Tel. No._________________ Mobile No.: _________________ Email: ____________________

Age: ____ Gender: ____ Date of Birth: _________ Place of Birth: ___________ Status: ______

School Background:

College/University: ____________________________Course: _______________ Year: ______

Are you a member of any art group?

oYes (Please indicate the name)_______________________________________________

oNo

How did you learn of the competition? (You may specify more than one)

o Poster

o Fellow Artist (word of mouth)

oFlyers

o Information Campaign

oArt Group

oFacebook

oEmail invitation

oOthers (please specify) _____________

I hereby swear to the truth of the foregoing information and that I have read and understood and will abide by the rules of the competition.

ENTRY NO.:______________________________________________Artist’s Signature over Printed Name

Data On The Painting

Title of Painting: _______________________________________________________________________________Medium/ Materials used: ____________________________________________

oPastel on Board Paper

oAcrylic on Canvass

Date Painting was Started: _________________________ Date Completed: _________________________

Please answer the following questions as briefly as you can (You may answer in Filipino):

1. What is your concept of hog raising in the Philippines?Before doing this artwork:_________________________________________________________________________________________________________________________________________________________________________________________________________________

After doing this artwork: _________________________________________________________________________________________________________________________________________________________________________________________________________________

2. What is the main message of your artwork?_________________________________________________________________________________________________________________________________________________________________________________________________________________

3. How does your painting inspire the industry of hog raising? _________________________________________________________________________________________________________________________________________________________________________________________________________________

2 by 2Photo

_____________________________________________Artist’s Signature over Printed Name

AFFIDAVIT

I,__________________________________, Filipino, ______ years old, single/married and residing at _____________________________________________________________ after having been duly sworn in accordance with the law, hereby depose and state that:

1. I am joining PIGtacular Nationwide Painting Competition and in connection therewith, I am submitting as my official entry, the painting entitled “_________________________________,” hereinafter called the “ENTRY”.

2. The ENTRY is my original and exclusive creation, being the result of my intellect and labor alone, and has not been copied from nor is similar to any previous or existing artwork (painting, design, sketch, photograph, etc.) in terms of composition or otherwise, even if rendered in a different style, medium or color scheme.

3. The decision of the Board of Judges as to whether my ENTRY is original shall be final and I bind myself to abide by said decision.

4. I began work on the above-stated ENTRY on ______________________ and completed and readied the same for competition on ___________________.

5. I unconditionally consent to the use of my winning entry for any UNAHCO material such as wall calendar, desk calendar, planner, address book, all-occasion cards, e-cards, and other products/items, and media without liability on the part of, or cost or fee to be paid by UNAHCO.

6. If I fail to claim my ENTRY on the dates specified in the rules, then I agree that it shall automatically become the property of Petron Corporation.

7. I have read and I will abide by the rules, regulations and requirements governing the above mentioned competition and, in this regard, I hereby exempt, discharge, release and free UNAHCO and its directors/trustees/officers and staff and shall defend and hold them free and harmless from any claim, liability or legal action arising from any potential or actual loss or damage arising from breach or falsity of any of my representations, acceptances or undertakings herein and from any claim or liability from any loss or damage which my ENTRY may suffer while being transported or while otherwise in the custody of the UNAHCO.

I am executing this affidavit to attest to the truth, veracity and validity of all the foregoing and to certify, under oath, originality, authenticity, and ownership of my above mentioned ENTRY, under pain of perjury.

In witness whereof, I have hereunto set my hand this __________ day of ____________________ 2012, in the City/ Province of ____________________.

______________________________ AFFIANT

REPUBLIC OF THE PHILIPPINES

SUBMITTED AND SWORN TO before me this _______ day of _____________ 20 _________, in _____________, affiant exhibiting his/her Community Tax Certificate No. ___________Issue at ________________ on _________, 20 ________.

Doc. No. ______________Page No. ______________Series of 2012