MISS FILIPINAS HERITAGE 2019

APPLICATION FORM

I. Name:_____________________________________________________________________
(Last name, First name, middle name)
II. Telephone No: ____________________________________________________________
III. E-mail add/s: ____________________________________________________________
IV. Facebook account/s : _____________________________________________________

V. Address
Street:_________________________________Barangay:________________________________
Town/ City___________________________ Province: _________________________________

VI. Birthday: __________________________________ Age: _________________________

VII. Height _________________________________ Weight ______________________

VIII. Other measurement

Bust Waist Hips Hair color Eye color

IX. Birthplace
Street:_________________________________Barangay:_________________________
Town/ City__________________________ Province: ___________________________

X. Mother’s Name:___________________________________________________________
Address: __________________________________________________________________
Contact Number __________________________________________________________

XI. Father’s Name:____________________________________________________________

Address: __________________________________________________________________
Contact Number __________________________________________________________

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

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

XII. Languages / dialects spoken: _____________________________________

___________________________________________________________________________

XIII. Citizenship __________________________ Gender : ___________________________

a. Citizenship in any country and details thereof:
COUNTRY NATURAL/NATURALIZED CURRENT STATUS
(If naturalized, date of naturalization)
__________________________________ _______________________________
________________________________ _______________________________
 XIV. EDUCATION
Level School Address Dates

Elementary

Secondary

Vocational/diplom
a
Tertiary

Post

XV. Occupation
Occupation Name of Company Place Contact Date
number

XVI. Other Contract

a. Details of all outstanding contracts, talent management and similar
agreements, sponsorships, endorsements and the like, (whether written and
oral)
Details Date Contact number

b. Past contracts, talent management and similar agreements, sponsorships,

endorsements and the like and details thereof:
c.
Details Date Contact number
 XVII. OTHER BEAUTY PAGEANTS joined for the past 3 years

Details Date Title

XVIII. Other information

Hobbies: Talents: Others

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 LAHIGNG PINOY-MISS FILIPINAS HERITAGE to reject this application,
without prejudice to any other remedies LAHING PINOY-MISS FILIPINAS
HERITAGE may have under the premises.

________________________________
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:
 MISS FILIPINAS HERITAGE 2019
Undertaking

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 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 would bring disrepute or embarrass to
Miss Filipinas-Heritage 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 Miss Filipinas-Heritage, prevent my qualifying as an applicant to or
candidate Miss Filipinas-Heritage.

I. 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)
d. Has not resided outside the Philippines
a. Valid ID showing Philippine address
e. 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.

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 Miss Filipinas-Heritage candidate 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 Miss Filipinas-Heritage 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.

Received: Close up photo Date: ___________

Received: Full body shot photo Date___________

E. I hereby authorize Miss Filipinas-Heritage 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 Miss Filipinas-

Heritage 2019 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 Miss Filipinas-Heritage and the qualifications of the
different international pageants before I can qualify as a candidate to the
Miss Filipinas-Heritage 2019 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 Miss Filipinas-

Heritage 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 Miss Filipinas-Heritage 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
Miss Filipinas-Heritage 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 Contract which I shall be required to sign
in case of wining considered as management contract.

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

sole discretion of Miss Filipinas-Heritage to accept or reject me as a
candidate to the Miss Filipinas-Heritage 2019 Pageant and that the decision
of Miss Filipinas-Heritage 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: