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 ofcial candidate and that any false misrepresentation I have made herewith is sufcient ground for my disqualifcation
from the contest.
Kindly submit the flled-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
Yes No
1.
2.
3.
ADDITIONAL INFORMATION
MSQCDJ No.____________
Applicants Signature
Parent / Guardians Signature
Conforme:
Date Submitted:
APPLICATION FORM
Please fll up in your own handwriting