BINIBINING PILIPINAS CHARITIES, INC.

2010 BINIBINING PILIPINAS BEAUTY PAGEANT

OFFICIAL APPLICATION FORM

(Please fill up in your own handwriting and submit to the Bb. Pilipinas Secretariat)

BINIBINING PILIPINAS CHARITIES, INC. (BPCI) DOES NOT COLLECT, NOR

HAS IT AUTHORIZED ANY PERSON/ENTITY TO COLLECT, ANY FEE IN
CONNECTION WITH THIS APPLICATION.

I. PERSONAL INFORMATION

A. I certify that all of the following matters indicated hereunder are true, and that
there are no false statements, misrepresentations or omissions herein. Any
such false statements, misrepresentations or omissions will be sufficient
ground for BPCI to reject this application, without prejudice to any other
remedies BPCI may have under the premises.

1. NAME ________________________________ SEX: ________________

a. NICKNAME ________________________
b. PEN NAME, STAGE NAME, OR PSEUDONYM ____________________

c. PRESENT ADDRESS:
House / Unit Number, Street: _________________________________
Barangay, City, Province: ____________________________________

d. If more than one address within the last five years, including foreign
addresses, indicate the same hereunder, as well as length of stay and
inclusive dates:

Address Length of Stay Inclusive Dates

1. _______________________ _____________ _____________
_______________________ _____________ _____________

2. _______________________ _____________ _____________

_______________________ _____________ _____________

3. _______________________ _____________ _____________

_______________________ _____________ _____________

(Please attacha separate sheet if more items needed)

2. CONTACT DETAILS
a. Landline Number ________________
b. Cellphone Number _______________
c. Email Address ___________________
d. I can most easily be reached or contacted through _______________.

3. AGE _______________

a. Place of Birth ________________________

b. Date of Birth _________________________

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4. CITIZENSHIP ________________________________

a. Citizenship in any country and details thereof:

COUNTRY NATURAL/NATURALIZED CURRENT STATUS

(If naturalized, date of naturalization)
__________________________________
__________________________________
__________________________________
__________________________________

b. Petitioned as resident or application for residency in any other country

and details thereof:

COUNTRY DATE OF APPLICATION CURRENT STATUS

(If naturalized, date of naturalization)
__________________________________
__________________________________
__________________________________
__________________________________
c. Status as immigrant to any other country and details thereof

COUNTRY DATE OF APPLICATION CURRENT STATUS

:
__________________________________
__________________________________
__________________________________
__________________________________
d. Application for naturalization in any other country and details thereof:

COUNTRY DATE OF APPLICATION CURRENT STATUS

__________________________________
__________________________________
__________________________________
__________________________________
e. Philippine Passport No. ______________________,
i. Issued at ___________________________
ii. Issued on __________________________
iii. Valid until_____________________
f. Details of foreign passport or any other foreign travel document:
__________________________________
__________________________________
__________________________________
__________________________________

5. DETAILS OF OCCUPATION
a. Present Occupation and Employment Address and Telephone Number/s:

Occupation Employment Address Tel. No.

_______________________ _________________ _______

b. Prior occupations and employment addresses:

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Occupation Employment Address Tel. No.

__________________________ ______________ ____________
__________________________ ______________ ____________

c. Details of all outstanding contracts, talent management and similar

agreements, sponsorships, endorsements and the like, whether written
and oral, with whom, and length of effectivity:

Contract With Whom Length of Effectivity

_______ ________________________ _____________________
_______ ________________________ _____________________
_______ ________________________ _____________________
_______ ________________________ _____________________

d. Past contracts, talent management and similar agreements,

sponsorships, endorsements and the like and details thereof:

Contract With Whom Length of Effectivity

_______ ___________________________ _____________________
_______ __________________________ _____________________
_______ ___________________________ _____________________
________ __________________________ _____________________

6. PARTICIPATION IN OTHER BEAUTY PAGEANTS

a. I have joined the following beauty contests at the given dates, winning
the following titles:

Beauty contest Title Date

__________________ ________________ ________________
__________________ ________________ ________________
__________________ ________________ ________________
__________________ ________________ ________________

b. I have appeared in the following TV show/s, movie/s and/or pictorial/s:

__________________________________
__________________________________
__________________________________
__________________________________

7. EDUCATION
a. Schools attended and address/es and date/s of graduation:

SCHOOL ADDRESS DIPLOMA/LEVEL DATE OF ISSUANCE

i. Elementary: ___________________________________________
ii. High School: ___________________________________________
iii. College: ___________________________________________
iv. Others: ___________________________________________

b. Highest educational attainment ________________________

c. Languages / dialects spoken: __________________________________
__________________________________________________________

8. OTHER PERSONAL INFORMATION:

A.Hobbies / sports activities / talents ______________________
__________________________________________________________
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B.Family:
i. FATHER’S OCCUPATION ADDRESS TEL/CELL
NAME
_____________ _________________ ____________________
_____________ ________________ ____________________
ii. MOTHER’S OCCUPATION ADDRESS TEL./CELL
_____________ ___________ _____________ __________
_____________ ___________ _____________ __________

iii. GUARDIAN’S OCCUPATION ADDRESS

TEL/CELL
NAME
____________ ___________ __________ _____________

____________ ____________ ___________ ______________

If parents are separated, who has legal custody if a minor?______________

Is separation legally documented? If yes, please provide valid order of
custody

a. Measurements:
i. Height: _________________
ii. Weight: _________________
iii. Bust: _________________
iv. Waist: _________________
v. Hips: _________________
b. Hair color __________________
c. Eye color __________________
d. At least three personal references who are non-relatives
NAME ADDRESS TEL/CEL NO.
i. _______________ __________________________ _____________

ii. _______________ __________________________ _____________

iii. _______________ __________________________ _____________

iv. _______________ __________________________ _____________

e. Reason for joining the 2009 Binibining Pilipinas Beauty Pageant:

_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

f. Other interesting personal information (if any): ______________________

_____________________________________________________________
_____________________________________________________________

B. I further certify that:

1. I am not married, have never been married, have never had a

marriage annulled or declared null and void, and that I have never
been nor am I now pregnant. I have never given birth to a child nor
am I a parent.

2. I am in good health, and have never been sick nor hospitalized for
cancer, epilepsy, HIV, AIDS, heart ailment, a disease involving the
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gastrointestinal system or any other disease that will impair my

physical or mental health or condition;

3. I am not, nor have I ever been under prolonged medication for any
physical, neurological, psychological or psychiatric condition;

4. I am of good moral character;

5. I have never participated in any bold show, play, movie or activity or

any show, play, movie of activity which, in the sole opinion of BPCI,
would be inconsistent with my application to the 2009 Binibining
Pilipinas Pageant (“2009 Pageant”) or would bring disrepute or
embarrass BPCI or any of its sponsors;

6. I have not engaged in prostitution or any act that can be deemed

related to such;

7. I am not a party to any existing contract which would, in the sole

opinion of BPCI, prevent my qualifying as an applicant to or
candidate of, the 2009 Pageant.

II. DOCUMENTS TO BE SUBMITTED:

A. Together with this Application Form, I am herewith submitting

copies of the following documents, and presenting the original documents
for comparison:

1. (Please check the applicable citizenship category)

a. Natural-born citizen born in the Philippines
i. Birth certificate; and
ii. Philippine passport, if applicable;
b. Balikbayan who reacquired Philippine citizenship
under RA 9225
i. Birth certificate or Report of birth; and
ii. Identification certificate issued by the Bureau of
Immigration
c. Natural-born citizen born outside the Philippines
i. Report of birth issued by the Philippine consulate in
the country of birth; or
ii. NSO certificate stating that birth was reported by the
Philippine consulate and recorded in the Philippines
2. (Please check the applicable residence category)
a. Has not resided outside the Philippines
g. Valid ID showing Philippine address
b. Has resided outside the Philippines
i. Valid ID showing Philippine address; and
ii. Any of the following;
1) Philippine passport;
2) Foreign passport; or
3) Certificate from the Bureau of Immigration
stating date of entry into the Philippines;
3. My high school or college diploma;
4. Medical Certificate for both my physical and mental health;
and
5. Certificate of good moral character given by my school,
church or professional organization.
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B. I am aware that I can be required to submit any other sufficient

proof of my age, residency, citizenship, health and other information
regarding my qualifications as BPCI may deem necessary.

C. I also warrant that the documents I have submitted are public

documents in my possession or which came into my possession and/or
are public documents attested by the officer having the legal custody of
the records, and that, where applicable, the entries therein were made in
the regular performance of official duty, and that I will hold BPCI free and
harmless from a breach of this warranty.

D. In addition to the documents listed above, I also submit two

photographs, one close-up and one full body shot.

(For BPCI)

Received: Close up photo Date: ___________

Received: Full body shot photo Date___________

E. I hereby authorize BPCI to verify the truth of all my assertions

herein and the genuineness/validity of all the documents I have submitted,
thereby waiving for these purposes the provisions of all laws, rules and
regulations, local or foreign, relating to the privacy or confidentiality of the
matters hereunder.

IV. UNDERSTANDING OF CONDITIONS

A. I understand that I am applying as a candidate to the 2009 Pageant and

that age, residency, and citizenship limits vary subject to the requirements of
the different international pageants and, accordingly, that my qualifications
are further subject thereto.

B. I understand that I have to pass the screening and meet all the
requirements of BPCI and the qualifications of the different international
pageants before I can qualify as a candidate to the 2009 Pageant. I further
understand that the basic requirements relate to information from me as
contained in this Application Form.

C. In considering my application to be a candidate to the 2009 National

Pageant, I also understand that personal achievement, intelligence, beauty,
physical fitness, personal style and charisma, among other criteria, shall also
be considered. I agree that all issues as to my eligibility as an applicant shall
be determined solely by BPCI and that I shall abide by its determination,
which shall be final and non-appealable.

D. In filling out and signing this Application Form, I further understand that
BPCI is under no obligation to accept me as a candidate. My acceptance as
official candidate shall commence only when I am formally and specifically
notified thereof.

E. If I am chosen as official candidate, this Application Form shall be

considered part and parcel of the Official Entry Form/Contract which I shall be
required to sign.

F. I understand that in signing this Application Form, I have accepted the

sole discretion of BPCI to accept or reject me as a candidate to the 2009
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Pageant and that the decision of BPCI on this application is final and non-
appealable.

G. I finally certify that I have read this Application Form carefully, that I have
understood the same, and that no promises or representations were made to
me to induce me to sign this Application Form.

________________________________
SIGNATURE ABOVE PRINTED NAME OF
APPLICANT

________________
Date

Signature/s above printed name of both parent/s (custodial parent if parents are
separated or if parent is solo parent) or of legal guardian, if applicant is a minor:

FATHER ____________________________________
MOTHER ____________________________________
LEGAL GUARDIAN _____________________________
Date:_________________________________________