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Application form (English)

※ Please fill out this form in Korean/English if possible!

Attach Name Donita Ellyzabeth Massa Height / Weight 160 / 54


Photo
Date of Birth (01 / 04 / 2002) (17)

Sex  Male Female

Family Massa Marriage □Married □Single

Address Bumi Kencana Asri, Perumahan Dharmais Jl. Mahoni III Block G No.1
RT 3 RW 13, Bogor, West Java, Indonesia 16167
Indonesian Country Bogor
Nationality
of Residence

PASSPORT □ Yes  No( please let me know how long it will take to get it : 5 days)
Possession

Occupation SMAN 10 BOGOR


(School/Company/
Organization)

E-mail Address donitellza@gmail.com

Phone Number 087777007977 Emergency Contact 08179000194


Information
(Parents, friends, etc.)

K-POP Related  Vocal  Dance  Choreography □ Composition Rap


Talent(Multi-choice Play instruments( )  Others( )
Allowed)

Other Talent MC Hobby Dancing,singing

Social Media YouTube -


Address
Instagram @donitzaa

Facebook -

Others -
(Twitter, Weibo)

Native Language Indonesian


Korean Language O □ X

Communication Level (Intermediate)

Speaking/Listening (Intermediate/)

Reading/Writing (Intermediate)

Other Languages Language (English) Communication Level (Advanced )

Language (Bahasa Indonesia) Communication Level (Advanced )

*Q&A

when i was 8th grade, i went to my friend's house and

she is playing GOT7 song's. I asked her who is the white


1. How did you get interested in K-POP?
hair one because he looks like an audition's (online

game) character and i strated to liking it until now.

KPOP affected my life so much. i felt like my whole world


have been changed and i'm really thankfull that kpop
exist in this world and come to me.
maybe other people thought that kpop it just a bunch of
people that dancing and singing on the stage. but it's
not, it's more than that. it's about the connection from
the idol to their fans, some other people may think that
people who likes kpop is a waste and stupid things to do.
but have ever know? that person who likes kpop, she's
suffering from her hard times until she found kpop, she
found happiness that no one can ever give to her. for me
2. How did K-POP affect you?
kpop is my life changing, yes that girl on the story was
me, before i know kpop i have one of my hardest time
that when my lovely family was in the end of the road,
yes we're having trouble at that time, i felt so lonely, even
i have a lot of friends, i don't know why i can't share my
story. i just can fake my smile, i can't even talk to my
closest friend. i shut everyones out, i became insiders. but
until i know kpop, i found my happiness, i became open
minded and finding new perspective, i makes new friends
from around the world, right now i'm doing dance cover
and i joined one of the biggest kpop community in
indonesia, i met amazing people that i can learn to. and
even i can talk korean right now, even not that good. I
don't know what i'm doing right now if i don't know
kpop.

3. Who is your favorite K-POP star (whom you want to Hwasa Mamamoo (my role model)

meet the most)? Mark GOT7 (the one who brings me to kpop)

4. What is your favorite K-POP song? Hwasa - twit

ITZY – DALLA DALLA

Hwasa - twit

PRODUCE48 – RUMOR

IOI- WHATTAMAN

Chungha – Gotta go

Momoland – BBoom BBoom

BLACKPINK – DDU DU DDU DU

BLACKPINK – AS IF IT’S YOUR LAST

BLACKPINK – FOREVER YOUNG


5. Please write down all the K-POP stars or songs you can
BLACKPINK – PLAYING WITH FIRE
cover.
BLACKPINK –WHISTLE

BLACKPINK – BOOMBAYAH

JENNIE – SOLO

PSY – NEW FACE

IZ*ONE- LA VIE EN ROSE

SUNMI- GASHINA

CLC-NO

CLC-HOBGOBLIN

CLC – BLACK DRESS


CLC – PEPE

GFRIEND – GLASS BEAD

GFRIEND – TIME FOR THE MOO NIGHT

GFRIEND – ME GUSTASTU

GFRIEND – ROUGH

GFRIEND – LOVE WHISPER

GFRIEND – NAVILLERA

BIGBANG – BANG BANG BANG

KARD – HOLA HOLA

RED VELVET – BAD BOY

RED VELVET –RUSSIAN ROULETTE

RED VELVET – RED FLAVOR

HYUNA – LIP & HIP

4MINUTE – CRAZY

4MINUTE – HATE

SNSD – HOLIDAY

SNSD – ALL NIGHT

SNSD – THE BOYS

SNSD – CATCH ME IF YOU CAN

SNSD – NEW INTO NEW WORLD

BTS – FIRE

BTS –

SISTAR – I LIKE THAT

SISTAR – SHAKE IT

EXID – LIE

EXID – Hot Pink


TWICE – Yes or Yes

TWICE – What is Love

TWICE – Likey

TWICE – Knock Knock

TWICE – Dance The Night Away

TWICE – Cheer Up

TWICE – TT

TWICE – OOH-AHH

TWICE – HeartShaker

TWICE – Signal

And a lot more

6. How long does it take you to cover a K-POP song? (how Dance : 5 MIN (REFF), 40 MIN (FULL SONG)

many times /how long) Song: 40 MIN

7. Please fill out all the experience related to K-POP?


Performing at KPOP event in Indonesia as Guest Star and
(including Broadcasting, Entertainment, Audition, Festival,
Special Performing, SM GLOBAL AUDITION 2017
Awards)

8. What are your other talents rather than singing/ dancing? DANCING

Perform dance cover at Breakout NET TV(Indonesian

9. Please fill out all the audition experience not related to Televison Channel), 1st Winner at Japanese Dance Cover

K-POP? (including Broadcasting Entertainment, Audition, in Indonesia, Perform in Japanese event as Guest Star and

Festival, Awards) Special Performance in Indonesia, JKT48 Audition, The

Next Boy\Girlband Indonesia audition

10. Have you seen any Korean TV programs? Yes, I’ve seen Produce 101, Produce 101 season 2, produce

(e.g. ‘Produce 101’/‘Goblin’/‘New Journey to the West’) 48, running man, my daughters’s man

11. Have you been to Korea before? -


(When/ Where / With whom/ Why/ How long)

12.If you've ever been to Korea, where have you been?


-
What was the most memorable/Impressive thing?

13. If you visit Korea what do you want to do the most?


Picnic at Han River
(Please write the reason)

14. If you visit Korea where do you want to go the most?


Nami Island
(Please write the reason)

15. If you visit Korea what do you want to eat the most?
Tteokbokki,Jajjangmyeon
(Please write the reason)

16. Are you available to stay in Korea for around a


yes
month(during March~April) (*If not, please write the reason.)

17. What do you think are the most attractive things


Eyes smile,
about yourself?

When I performed on stage and seeing a lot of people


18. When was the happiest moment in your life?
smiling and cheering up

When i agreed with other people’s mind that someone


19. When was the most difficult moment in your life?
like me can’t be an idol

20. What is a final goal you want to achieve through K- Being an kpop idol, learn many things usefull, became

POP? more strong mentally, improving my skill

Maybe I’m not that pretty, I’m not skinny, but you know
21. Any last comments or questions?
I’m the one you’re looking for
< A Guide for Additional Files >
① Application

② Attach Photos:A total of three photos


- From front / From Side / Full Length

(Photos from the front/side should be taken in a bust shot,


and full length should include full-length of your body from head to foot)
③ Attach Videos :A total of three videos
- Self-Introduction video/ K-POP cover dance video/ K-POP cover song(rap acceptable)
- Introduction (native language / Korean if possible) must be filmed in bust shot.

- Please tell us how much you love K-POP in your self-introduction video clip
(*Each video should not exceed more than 2 minutes)
※ Not with other members in your video. Please attach video of you alone.

- Please do not wear too much makeup.

- No Filter or Photoshop. No Camera App (e.g. SNOW, B612)

- Please attach photo/video in which your face is identifiable.

<Collection and use of personal information>

➀ Information to be collected: Photos, Occupation, Name, Sex, Social Media Address, Date of Birth, Family Information,

Marriage, Home Address, Phone Number, E-mail Address, School, Job, Videos You Submitted, Career.

➁ Collection and Use:Participation and acceptance of Mnet <유학소녀 :Ticket To K-POP>program.

➂ Limitation of using the information: personal information collected for Mnet <유학소녀 :Ticket To K-POP>

will be only limited to the end of the program and will maintain it from the day when you signed this consent to the day

when the purpose of collection, use and limitation of the information is served fully. Follow all CJ ENM laws about the

privacy.

➃ Disadvantage if one disagrees: If the person does not agree with the contents above, Mnet determines that she

does not intent to participate in the program. If she agrees, she must fully perform the task.

I give my consent to Mnet to collect and use my personal information

for the work related to the program. 


NAME (Donita E. M.)

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