HIYAS SANG BOTONG 2019

Barangay Botong, Oton, Iloilo

OFFICIAL APPLICATION FORM

HIYAS SANG BOTONG. 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 Hiyas sang Botong solely for the purpose of determining and evaluating your fitness and
eligibility to join the Hiyas sang Botong 2019 Pageant.
2. This Application Form and all other documents that are required from you will be stored until the
end of the Pageant Night.
3. Upon reasonable demand before the Pageant 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 Reynore Kent Canto the director at 09304243196 or e-mail reyken1321@gmail.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 Hiyas sang Botong to determine
your eligibility to join the 2019 Pageant;
ii. You likewise categorically and explicitly authorize Hiyas sang Botong, its directors/chairman
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 you consent and that
you do so freely, knowingly, voluntarily, willingly and undear 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 Reynore Kent Canto)

I. PERSONAL INFORMATION

FULL NAME NICKNAME

PEN NAME/STAGE NAME/PSEUDONYM SEX
PRESENT ADDRESS

(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

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 CONTACT DETAILS
LANDLINE MOBILE EMAIL
I can most easily be reached/contacted through:

AGE
PLACE OF BIRTH DATE OF BIRTH

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

a. Past Occupation/s
OCCUPATION EMPLOYER/EMPLOYER ADDRESS CONTACT NO.

PARTICIPATION IN OTHER BEAUTY PAGEANTS

BEAUTY CONTEST/ORGANIZER TITLE WON DATE

EDUCATION
SCHOOL/UNIVERSITY ADDRESS DEGREEE/LEVEL YEAR
GRADUATED

HIGHEST EDUCATIONAL ATTAINMENT

LANGUAGE/DIALECT SPOKEN

OTHER PERSONAL INFORMATION

HOBBIES:
SPORTS ACTIVITIES
TALENT/SKILLS
HANDLER

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 FAMILY BACKGROUND
NAME OCCUPATION ADDRESS CONTACT NO/S.
FATHER
MOTHER

GUARDIAN
(if any)

BODY MEASUREMENT
Height Weight Hair Color Hair Color
Bust Waist Hips

PERSONAL REFERENCES
NAME ADDRESS CONTACT NO
1.
2.
3.

II. CERTIFICATION AND WARRANTY OF INRMATION/STATEMENTS

1. I certify all of the following information/data and/or matters indicated in the Application
Form and such documents attached hereto are true, and that there are no false
statements, mispresentations or omissions herein. Any such false statements,
mispresentations or omissions will be sufficient ground for HSB to reject this application,
without prejudice to any other legal remedies HSB may be entitled to under premises.
2. I further certify that:
a. I am in good mental , psychological and physical health, and that I have
never been sick or have hospitalized for Cancer, Epilepsy, HIV, AIDS, any
heart ailment, a disease involving the gastrointestinal system or any other
disease that will impair by mental, psychological and/or physical health
condition;
b. 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;
c. I am of good moral character;
d. I have not engaged in prostitution or any such act which can be deemed as
similar or related thereto;
e. I was born with the anatomy of 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.

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 III. DOCUMENTS TO BE SUBMITTED (attached to this Application.)

Photocopy of Birth Certificate

Barangay Clearance

Close-up Photo

Full Photo

IV. UNDERSTANDING OF CONDITIONS

1. I understand that I am applying as a candidate of Hiyas sang Botong 2019 Pageant and
that the requirements and/or limitations with regard age, residency, and citizenship may
vary, subject to the requirements of different pageants, and that accordingly; my
qualifications are further subject thereto.
2. I am aware the HSB, 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 HSB
with such requested documentation/information, and failing to comply within the period to
submit, as determined by HSB, I understand that my application will not be considered
complete and submitted.
3. I 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 HSB and that shall abide by its
determination, which shall be final and non-appealable.
4. In filling out and signing this Application Form, I further understand that HSB 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 HSB.
5. I understand that in signing this Application Form, I have accepted the sole discretion of
HSB 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.
6. 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 signs 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 minor:)

FATHER ________________________________________ Date _________________

MOTHER ________________________________________ Date __________________

LEGAL GUARDIAN ________________________________________ Date __________________

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