The search is on for the next MISS SILKA CAGAYAN 2011

2. CONTACT DETAILS
a. Landline Number _______________
Do you have what it takes to be Cagayan de Oro’s next Miss Silka
Cagayan 2011? Do you aspire to be next Miss Silka Philippines 2011? b. Cellphone Number _______________
c. Email Address _______________
If you believe that your beauty is world-class enough to be crowned the Gabor Building, Capistrano-Kalambaguhan St., Cagayan de Oro City
next Miss Silka Philippines 2011, then take the first big step to realizing d. I can most easily be reached or contacted through _____________
Call/Text: 09267724999 / 09323722995 / 09394242468
your goals and grab this rare chance NOW. Email us at: bong_acharon2000@yahoo.com or 3. AGE _______________
www.samichellacreations@yahoo.com a. Place of Birth ________________________
Miss Silka Cagayan 2011 has now formally opened its application Visit us at: samichellacreations.multiply.com or b. Date of Birth ________________________
process for Cagayan de Oro’s aspiring beauty queens. Contestants must misssilkacagayan.multiply.com
be single ladies from 16-23 years old of Filipino citizenship, with a Facebook: misssilkacagayan@ymail.com 4. CITIZENSHIP ________________________________
minimum height of 5’3” and has a good moral character. 5. DETAILS OF OCCUPATION
a. Present Occupation and Employment Address and Telephone
Application forms may be secured from your local Barangay or from the Number/s:
SCEO Secretariat at Gabor Bldg., Capistrano-Kalambaguhan Sts., Occupation Address Tel. No.
(between old Rizal theater and Llamados bar) Cagayan de Oro City. _________________ ___________________ ___________________
Telephone nos.: (088) 309-2632; (088) 309-3645; 852-4854; Mobile nos.:
09267724999 (TM); 09323722995 (Sun); 09394242468 (Smart). You b. Prior occupations and employment addresses:
may also email us at www.samichellacreations@yahoo.com or download Occupation Address Tel. No.
the form at our Multiply account at samichellacreations.multiply.com or _________________ ___________________ ___________________
misssilkacagayan.multiply.com or join us at Facebook at Silka Cagayan; _________________ ___________________ ___________________
and submit it personally to SCEO Secretariat at the above mentioned OFFICIAL APPLICATION FORM
6. PARTICIPATION IN OTHER BEAUTY PAGEANTS
address. Please fill up in your own handwriting and submit to: a. I have joined the following beauty contests at the given dates, winning
SAMICHELLA’S CREATIONS & EVENT ORGANIZER SECRETARIAT the following titles:
QUALIFICATIONS ------------------------
SAMICHELLA’S CREATIONS & EVENT ORGANIZER (SCEO) DOES Beauty contest Title Date
16 - 23 years old NOT COLLECT, NOR HAS IT AUTHORIZED ANY PERSON / ENTITY ____________________________ _______________ ____________
A resident of the area: TO COLLECT ANY FEE IN CONNECTION WITH THIS APPLICATION ____________________________ _______________ ____________
From Cagayan de Oro City up to Balingasag & El Salvador, Misamis ____________________________ _______________ ____________
Oriental I. PERSONAL INFORMATION
b. I have appeared in the following TV show/s, movie/s and/or pictorial/s:
At least 5'3" A. I certify that all of the following matters indicated hereunder are true, __________________________________________________________
Single, no child and that there are no false statements, misrepresentations or omissions __________________________________________________________
Has a good moral character herein. Any such false statements, misrepresentations or omissions will
be sufficient ground for SCEO to reject this application, without prejudice 7. EDUCATION
Fair and smooth complexion
to any other remedies SCEO may have under the premises. a. Schools attended and address/es and date/s of graduation:
No tattoos or body markings
8. SCHOOL ADDRESS DIPLOMA/LEVEL DATE OF ISSUANCE
NAME ________________________________ SEX: _______________
SCREENING SHEDULES: i. Elementary: ___________________________________________
a. NICKNAME ________________________ ii. High School: ___________________________________________
First Screening : May 27, 2011 (3PM) Brgy. Nazareth Gym
iii. College: ______________________________________________
Second Screening : June 10, 2011 (3PM Brgy. Tablon Gym b. PEN NAME, STAGE NAME, OR PSEUDONYM _________________
iv. Others: _______________________________________________
Third Screening : June 24, 2011 (3PM) The Marigold Hotel c. PRESENT ADDRESS: a. Highest educational attainment ______________________________
Fourth Screening : July 1, 2011 (3PM) Brgy. Bulua Gym House / Unit Number, Street: _________________________________ b. Languages / dialects spoken: ________________________________
Barangay, City, Province: ____________________________________ ________________________________________________________
PRESS-CONFERENCE d. If more than one address within the last five years, including foreign 9. OTHER PERSONAL INFORMATION:
July 8, 2011 (3PM) addresses, indicate the same hereunder, as well as length of stay and a. Hobbies / sports activities / talents __________________________
inclusive dates:
MAIN EVENT SCHEDULE: B. Family:
Address Length of Stay Inclusive Dates
Talent Competition : July 09, 2011 (3PM)
1. ___________________________ __________ _____________ FATHER’S NAME OCCUPATION ADDRESS TEL/CELL
Gaisano Mall Activity Area
___________________________ __________ _____________ ______________ __________ _________________ ____________
2. ___________________________ __________ _____________
Swimsuit Competition : July 14, 2011 (3PM) MOTHER’S NAME OCCUPATION ADDRESS TEL/CELL
___________________________ __________ _____________
Marco Hotel ______________ __________ _________________ ____________
3. ___________________________ __________ _____________
___________________________ __________ _____________ GUARDIAN’S NAME OCCUPATION ADDRESS TEL/CELL
Coronation Night : July 16, 2011 (4PM) _______________ __________ _________________ ___________
The Atrium, Limketkai Mall (Please attached separate sheet if more items needed)
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:
Height : _________________ Weight : _________________
Bust : ___________________ Waist : _________________
Hips : ___________________
b. Hair color : __________________
c. Eye color : __________________
d. At least three personal references who are non-relatives
NAME ADDRESS TEL/CEL. NO.
__________________ ________________________ ______________
__________________ ________________________ ______________
__________________ ________________________ ______________
e. Reason for joining the MISS SILKA CAGAYAN 2011 BEAUTY PAGEANT
_______________________________________________________________
f. Other interesting personal information (if any):
________________________________________________________
C. I, further certify that:
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.
I am in good health, and have never been sick or 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;
I am not, nor have I ever been under prolonged medication for any physical,
Neurological, Psychological or Psychiatric condition; I am of good moral character;
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 SCEO, would be inconsistent
with my application to the MISS SILKA CAGAYAN 2011 BEAUTY PAGEANT or
would bring disrepute or embarrass SCEO or any of its sponsors; I have not
engaged in prostitution or any act that can be deemed related to such; I am not a
party to any existing contract which would, in the sole opinion of SCEO, prevent
my qualifying as an applicant to or candidate of, the 2011 Pageant.
II. DOCUMENTS TO BE SUBMITTED:
Together with this Application Form, I am herewith submitting copies of the
following documents, and presenting the original documents for comparison:
1. Natural-born citizen born in the Philippines
2. Birth certificate
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
SCEO may deem necessary.
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 5 the regular performance of official
duty, and that I will hold SCEO free and harmless from a breach of this warranty.
In addition to the documents listed above, I also submit two photographs, one
close-up and one full body shot.
(For SCEO)
Received: ___________________
Close up photo Date: ___________
Received: ___________________
Full body shot photo Date: ___________
I hereby authorize SCEO 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
I understand that I am applying as a candidate to the MISS SILKA CAGAYAN
2011 BEAUTY PAGEANT and that age, residency, and citizenship limits may vary
subject to the requirements that my qualifications are further subject thereto.
I understand that I have to pass the screening and meet all the requirements of
SCEO before I can qualify as a candidate to the 2011 Pageant. I further
understand that the basic requirements relate to information from me as contained
in this Application Form.
In considering my application to be a candidate to the 2011 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 SCEO and that I shall abide by its determination, which shall be final and non-
appealable.
In filling out and signing this Application Form, I further understand that SCEO 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.
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.
I understand that in signing this Application Form, I have accepted the sole
discretion of SCEO to accept or reject me as a candidate to the 2011 Pageant and
that the decision of SCEO on this application is final and non-appealable.
I further agree that in the event that I will be accepted to be one of the Candidates
after the Pre-Screening, I shall not back-out/withdraw during or before the
Coronation Night (Except those reasons that will fall or considered as Emergency
in nature e.g. deaths, accidents or other natural calamities). If such subject arise, I
am liable to pay SCEO an amount of P 10,000.00 as damages/remedies that
SCEO may have undertaken/prepared of the said pageant.
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
Signature/s above printed name of both parent/s
_____________________
Date
FATHER’S NAME : ____________________________________
MOTHER’S NAME : ____________________________________
LEGAL GUARDIAN : ____________________________________
Date : ____________________________________