BINIBINING PILIPINAS CHARITIES, INC.

2019 BINIBINING PILIPINAS BEAUTY PAGEANT

OFFICIAL APPLICATION FORM

BINIBINING PILIPINAS CHARITIES, INC. (BPCI) NEITHER COLLECTS NOR HAS IT AUTHORIZED ANY
PERSON/ENTITY TO COLLECT ANY FEE IN CONNECTION WITH THIS APPLICATION.
PLEASE READ BEFORE FILLING OUT THIS APPLICATION FORM:
In compliance with the provisions of the Data Privacy Act of 2012 (Republic Act No. 10173), you are hereby
given notice that:
1. The information and supporting documents that you are about to provide or have provided will be used
by BPCI solely for the purpose of determining and evaluating your fitness and eligibility to join the 2019
Binibining Pilipinas Beauty Pageant (“2019 Pageant”).
2. This Application Form and all other documents that are required from you will be stored in BPCI’s office
th
at the 26 Floor Gateway Tower, Araneta Center, Quezon City, until the 2020 Binibining Pilipinas Beauty
Pageant Coronation Night.
3. Upon reasonable demand before the 2020 Binibining Pilipinas Beauty Pageant Coronation Night, you will
have the right to access this Application Form and all documents you have submitted; correct
inaccuracies or errors in the information provided; and suspend, withdraw or order the blocking removal
or destruction of any and all information and documents provided;
4. You may call BPCI at 588-4000 loc. 4103 or e-mail bpci@aranetagroup.com for all concerns related to
the information provided in this Application Form and all other documents required to be submitted.

By affixing you signature below, you represent and warrant that:

i. All information that you will provide or have provided are true and correct to the best of your
knowledge, freely and voluntarily given for purposes of allowing BPCI to determine your eligibility
to join the 2019 Pageant;
ii. You likewise categorically and explicitly authorize BPCI, its directors/trustees, officers,
employees and duly authorized representatives, including its subsidiaries and affiliates, to keep,
store, use, access and process all information that you will provide or have provided in this
Application Form and the documents required to be submitted.
iii. You fully understand and confirm that signing this document means giving your consent and that
you do so freely, knowingly, voluntarily, willingly and under no duress, and that your application
for entry into the 2019 Pageant as a prospective candidate will not be processed or entertained
without first affixing your signature below.

__________________________________ ______
Applicant’s Signature over Printed Name Date

(Please fill out this Application Form in your own handwriting and submit to BPCI Secretariat)

I. PERSONAL INFORMATION

FULL NAME NICKNAME

PEN NAME/STAGE NAME/PSEUDONYM SEX

PRESENT ADDRESS
House No./Unit No./Condominium Street

Barangay City/Municipality Province

(If more than one address within the last five (5) years, including foreign addresses, kindly indicate the same below
as well as length of stay and inclusive dates. Attach a separate sheet if necessary)
ADDRESS LENGTH OF STAY INCLUSIVE DATES

1.

2.

3.

1|Page
 CONTACT DETAILS

LANDLINE MOBILE EMAIL

I can most easily be reached/contacted through:

AGE
PLACE OF BIRTH DATE OF BIRTH
mm / dd / yyyy

CITIZENSHIP

a. Citizenship In Any Country and Details Thereof:

NATURAL-BORN OR NATURALIZED
COUNTRY CURRENT STATUS
(If Naturalized, date of Naturalization)

b. Petitioned as Resident or Application for Residency in any Other Country and Details Thereof:

NATURAL-BORN OR NATURALIZED
COUNTRY 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

2|Page
 PASSPORT DETAILS

Place Issued Date Issued Valid Until

mm / dd / yyyy mm / dd / yyyy
Details of Foreign Passport or any other Foreign Travel Document (if any):

OCCUPATION

a. Present Occupation:
OCCUPATION EMPLOYER/EMPLOYER ADDRESS CONTACT NO.

b. Past Occupation/s:
OCCUPATION EMPLOYER/EMPLOYER ADDRESS CONTACT NO.

c. Details of ALL OUTSTANDING CONTRACTS for Talent Management and Similar Agreements, as
well as for Sponsorships, Endorsements and the like, whether written or verbal (attach additional
sheets if necessary)
CONTRACT DESCRIPTION WITH WHOM LENGTH OF VALIDITY

d. Details of ALL PAST CONTRACTS for Talent Management and Similar Agreements, as well as for
Sponsorships, Endorsements and the like, whether written or verbal (attach additional sheets if
necessary)
CONTRACT DESCRIPTION WITH WHOM LENGTH OF VALIDITY

e. I Have Appeared and/or Currently Appear in the Following TV Show(s), Movie(s) and/or
Pictorial(s) (attach additional sheets if necessary)
MEDIA (TV Show, Movie, Pictorial) ROLE INCLUSIVE DATES

NOTE: For items (c), (d) and (e) of OCCUPATION, the APPLICANT is REQUIRED to DISCLOSE ALL
PRESENT and PAST Contracts, Talent Management and Similar Agreements, Sponsorships, Endorsements
and the like, including Fashion Shows and/or Print and Video Modeling Jobs and PROVIDE BPCI with
copies of Media the Applicant has appeared in.

3|Page
 PARTICIPATION IN OTHER BEAUTY PAGEANTS
BEAUTY CONTEST/ORGANIZER TITLE WON DATE

EDUCATION
YEAR CONTACT
SCHOOL/UNIVERSITY ADDRESS DEGREE/LEVEL
GRADUATED PERSON/DETAILS

HIGHEST EDUCATIONAL ATTAINMENT

LANGUAGES/DIALECTS SPOKEN

OTHER PERSONAL INFORMATION

HOBBIES

SPORTS ACTIVITIES

TALENTS/SKILLS

HANDLER

FAMILY BACKGROUND
NAME OCCUPATION ADDRESS CONTACT NO/S.

FATHER

MOTHER
GUARDIAN
(if any)
If Parents are separated, who has legal custody (if Applicant is a minor):

Is the separation of the Parents legally documented? (YES or NO)

NOTE: If Parents’ separation is legally documented, please provide VALID ORDER of CUSTODY.

BODY MEASUREMENTS AND INFORMATION

Height Weight Hair Color Eye Color

Bust Waist Hips

4|Page
 PERSONAL REFERENCES
(Provide at least three (3) reference who are NOT your relatives)

NAME ADDRESS CONTACT NO/S.

1.

2.

3.

Reason/s for applying for or wanting to join the 2019 Pageant:

Other interesting personal information (if any):

5|Page
II. CERTIFICATION AND WARRANTY OF INFORMATION/STATEMENTS

1. I certify that all of the following information/data and/or matters indicated in this Application Form and
such documents attached hereto 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 legal remedies BPCI may be entitled to
under the premises.

2. I further certify that:

a. I am neither married, nor have I ever been married; I have never sought the annulment of my
marriage or the declaration of nullity thereof; I have never been, nor am I presently, pregnant. I have
neither given birth to a child nor am I a parent;

b. I am in good mental, psychological and physical health, and that I have never been sick or have
been hospitalized for Cancer, Epilepsy, HIV, AIDS, any heart ailment, a disease involving the
gastrointestinal system or any other disease that will impair my mental, psychological and/or physical
health or condition;

c. I am neither suffering from, nor have I ever been under prolonged medication for, any physical,
neurological, psychological or psychiatric condition, including any eating and/or personality disorders
which will impair my ability to act as an Applicant and/or Candidate of the 2019 Pageant;

d. I am of good moral character;

e. I have never participated in any bold/burlesque shows, plays, movies, publications or activities, or
such show, play, movie, publication or activity, which, in the sole opinion and discretion of BPCI, is
inconsistent with my application to the 2019 Pageant, run counter against the social and moral
principles upon which the Pageant is founded, and/or bring disrepute or embarrassment to BPCI or
any of its sponsors;

f. I have not engaged in prostitution or any such act which can be deemed as similar or related thereto;

g. I am not a party to any existing Contract, which, in the sole opinion and discretion of BPCI, shall
cause my disqualification as an Applicant to, or a Candidate of, the 2019 Pageant; and

h. I was born with the anatomy of a female and that I have not consented to and/or underwent any
surgical, medical and/or cosmetic procedure to transform myself into a biological female.

III. DOCUMENTS TO BE SUBMITTED

1. Attached to this Application Form is/are ____ copy(ies) of the following documents, the original of which I
am presenting to the BPCI Corporate Secretariat for comparison and verification:

a. CITIZENSHIP (Please check applicable Citizenship category)

Balikbayan Who Re-Acquired

Natural-Born Citizen
Born In the Philippines
i. Birth certificate
ii. Philippine passport, if applicable
Philippine Citizenship under
R.A. 9225
i. Birth Certificate or Report of
Birth; and
ii. Identification certificate issued
by the Bureau of Immigration:
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

b. RESIDENCE (Please check applicable Residence category)

Has Not Resided Outside the Philippines Has Resided Outside the Philippines
i. Valid ID Showing Philippine Address i. Valid ID showing Philippine Address; and
ii. Any of the following:
a. Philippine Passport;
b. Foreign Passport; or
c. Certificate from Bureau of Immigration stating
date of entry into the Philippines

c. High School or College Diploma;

d. Medical Certificate for both my Physical and Mental health and well-being; and
e. Certificate of Good Moral Character given by my School, Church or Professional Organization.

6|Page
 2. In addition to the documents listed above, I also submit two (2) photographs, one close-up and one full
body shot. (To be accomplished by BPCI)

Close-up Photo Received by: Date received:

Full Body Shot Photo Received by: Date received:

3. 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.

4. I warrant that the documents I have submitted are public documents in my possession or which came
into my possession legally and/or are public documents attested to by the officer/s having the legal
custody of the records, and that, where applicable, the entries therein were made in the regular
performance of an official duty, and that I will hold BPCI free and harmless from any breach of this
Warranty.

IV. UNDERSTANDING OF CONDITIONS

1. I understand that I am applying as a candidate in the 2019 Pageant and that the requirements and/or
limitations with regard to age, residency, and citizenship may vary, subject to the requirements of
different international pageants, and that accordingly, my qualifications are further subject thereto.

2. I am aware that BPCI, in its sole discretion, may require me to submit additional and sufficient proof of
age, residency, citizenship, health and other documentation/information regarding my qualifications.
Should I be required to do so, I undertake to provide BPCI with such requested
documentation/information, and failing to comply within the period to submit, as determined by BPCI, I
understand that my application will not be considered complete and submitted.

3. I understand that I have to pass the screening and meet all the requirements and qualifications of BPCI
and of the different international pageants before I can qualify as a candidate in the 2019 Pageant. I
further understand that the basic requirements relate to information obtained from me as contained in this
Application Form.

4. In considering my application to be a candidate in the 2019 Pageant, I understand that personal

achievements, intelligence, beauty, physical fitness, personal style and charisma, among other criteria,
shall also be considered. I agree that all issues relating 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.

5. 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 an official candidate shall commence only when I am
formally and specifically notified thereof by BPCI.

6. If I am chosen as an official candidate, this Application Form shall be considered part and parcel of the
Official Entry Form/Contract which I shall be required to sign.

7. I understand that in signing this Application Form, I have accepted the sole discretion of BPCI to accept
or reject me as a candidate in the 2019 Pageant and that the decision of BPCI on this application is final
and non-appealable.

8. 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 induce me to sign this Application Form.

____________________________________ _____________
Applicant’s Signature over Printed Name Date

Signature/s above printed names of both Parent/s (Custodial Parent if Separated or if parent is Solo Parent) or
of Legal Guardian, if applicant is a minor:)

FATHER ____________________________________ Date ______________

MOTHER ____________________________________ Date ______________

LEGAL GUARDIAN ____________________________________ Date ______________

7|Page