ANG PAGFILL-UP KOP NG BB.PILIPINAS FORM.WALANG AAPILA.

BINIBINING PILIPINAS CHARITIES, INC.
2009 BINIBINING PILIPINAS BEAUTY PAGEANT

OFFICIAL APPLICATION FORM

(Please fill up in your own handwriting and submit to the Bb. Pilipinas Secretariat)

BINIBINING PILIPINAS CHARITIES, INC. (BPCI) DOES NOT COLLECT, NOR HAS IT AUTHORIZED ANY PERSON/ENTITY TO COLLECT, ANY FEE IN CONNECTION WITH THIS APPLICATION.


I. PERSONAL INFORMATION

A. 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 for BPCI to reject this application, without prejudice to any other remedies BPCI may have under the premises.

1. NAME: HANNAH GRACE S. MESDE SEX: FEMALE
a. NICKNAME: NAJAH,CHICHAY
b. PEN NAME, STAGE NAME, OR PSEUDONYM:PORTIA,EUTERPE

c. PRESENT ADDRESS:
House / Unit Number, Street:B2 L28 P-3
Barangay, City, Province: ST.JAMES BATAL, SANTIAGO CITY,ISABELA

d. If more than one address within the last five years, including foreign addresses, indicate the same hereunder, as well as length of stay and inclusive dates:

Address Length of Stay Inclusive Dates
_______________________ _____________ _____________
_______________________ _____________ _____________
_______________________ _____________ _____________
_______________________ _____________ _____________
_______________________ _____________ _____________
_______________________ _____________ _____________


2. CONTACT DETAILS
a. Landline Number 682-47-98
b. Cellphone Number 09057133414
c. Email Address Hannah_mesde@yahoo.com.
d. I can most easily be reached or contacted through:e-mails and sms/calls

3. AGE: 16

a. Place of Birth: BAPTISTA VILLAGE, SANTIAGO CITY
b. Date of Birth: APRIL 19,1992

4. CITIZENSHIP: FILIPINA

a. Citizenship in any country and details thereof:
__________________________________
__________________________________
__________________________________
__________________________________

b. Petitioned as resident or application for residency in any other country and details thereof:
__________________________________
__________________________________
__________________________________
__________________________________
c. Status as immigrant to any other country and details thereof:
__________________________________
__________________________________
__________________________________
__________________________________
d. Application for naturalization in any other country and details thereof:
__________________________________
__________________________________
__________________________________
__________________________________
e. Philippine Passport No. ______________________,
i. Issued at ___________________________
ii. Issued on __________________________
iii. Valid until_____________________
f. Details of foreign passport or any other foreign travel document:
__________________________________
__________________________________
__________________________________
__________________________________

5. DETAILS OF OCCUPATION
a. Present Occupation and Employment Address:

Occupation Employment Address
__________________________ __________________________

b. Prior occupations and employment addresses:

Occupation Employment Address
__________________________ __________________________
__________________________ __________________________

c. Details of all outstanding contracts, talent management and similar agreements, sponsorships, endorsements and the like, whether written and oral, with whom, and length of effectivity:

Contract Length of Effectivity
__________________________________ _____________________
__________________________________ _____________________
__________________________________ _____________________
__________________________________ _____________________

d. Past contracts, talent management and similar agreements, sponsorships, endorsements and the like and details thereof:

Contract Length of Effectivity
__________________________________ _____________________
__________________________________ _____________________
__________________________________ _____________________
__________________________________ _____________________

6. PARTICIPATION IN OTHER BEAUTY PAGEANTS
a. I have joined the following beauty contests at the given dates, winning the following titles:

Beauty contest Title Date
__________________ ________________ ________________
__________________ ________________ ________________
__________________ ________________ ________________
__________________ ________________ ________________

b. I have appeared in the following TV show/s, movie/s and/or pictorial/s:
__________________________________
__________________________________
__________________________________
__________________________________

7. EDUCATION
a. Schools attended and address/es and date/s of graduation:
i. Elementary: ___________________________________________
ii. High School: ___________________________________________
iii. College: ___________________________________________
iv. Others: ___________________________________________

b. Highest educational attainment ________________________
Languages / dialects spoken: ENGLISH,TAGALOG,PAMPANGENO,KOREAN,JAPANESE

8. OTHER PERSONAL INFORMATION:
a. Hobbies / sports activities / talents PLAYING MUSICAL INSTRUMENTS, NOVELIST,POET,WRITER, WEBPAGE WRITER.
b. Family:
FATHER’S NAME, OCCUPATION AND ADDRESS: RUBEN J. MESDE, BUSINESSMAN, ST.JAMES BATAL.
i. MOTHER’S NAME, OCCUPATION AND ADDRESS: GEMMA MESDE,HOUSEKEEPER, ST.JAMES BATAL.
ii. GUARDIAN’S NAME, OCCUPATION AND ADDRESS ____________ ________________________________________________________
c. Measurements:
i. Height: 5’5
ii. Weight: _________________
iii. Bust: _________________
iv. Waist: 28’
v. Hips: _________________
d. Hair color: BLACK
e. Eye color:BROWN
f. At least three personal references who are non-relatives (indicate names addresses and telephone numbers):

i. _______________ _____________________________ _____________

ii. _______________ _____________________________ _____________

iii. _______________ _____________________________ _____________

iv. _______________ _____________________________ _____________

g. Reason for joining the 2009 Binibining Pilipinas Beauty Pageant: _____________________________________________________________ __________________________________________________________________________________________________________________________

h. Other interesting personal information (if any): ______________________ __________________________________________________________________________________________________________________________


B. 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, in the sole opinion of BPCI, would be inconsistent with my application to the 2009 Binibining Pilipinas Pageant (“2009 Pageant”) or would bring disrepute or embarrass BPCI 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 BPCI, prevent my qualifying as an applicant to or candidate of, the 2009 Pageant.

II. 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)
a. Has not resided outside the Philippines
i. Valid ID showing Philippine address
b. 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 BPCI 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 BPCI 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.

E. 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.

III. UNDERSTANDING OF CONDITIONS

A. I understand that I am applying as a candidate to the 2009 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 BPCI and the qualifications of the different international pageants before I can qualify as a candidate to the 2009 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 the 2009 National 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 BPCI 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 BPCI 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 Official Entry Form/Contract which I shall be required to sign.

F. I understand that in signing this Application Form, I have accepted the sole discretion of BPCI to accept or reject me as a candidate to the 2009 Pageant and that the decision of BPCI 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.



HANNAH Grace Mesde
APPLICANT’S SIGNATURE


JANUARY 19,2008
Date


IKATSUKA
SIGNATURE/S OF PARENT/S/GUARDIAN,
IF APPLICANTIS A MINOR