Miss Teen Philippines 2014 Application Form PERSONAL NFORMATION Name:

Irish Dianne E. Tarun

Nickname: ayeng

Sex: (Tick applicable box) Male Female Present address: #19 petronia st. novaliches quezon city

Barangay, City, Province: Sta. Isabel Sur Ilagan Isabela Contact details: Landline: Cellphone: 09062985924 Email: Age: 15 irishdianetarun@yahoo.com Place of birth: Lying in novaliches quezon city EDUCATION Date of birth: June 15, 1998

School

School Address

Degree/Level

Year Graduated

Highest educational attainment: Other educational Programs attended:

Educational/Leadership achievements: School Grade Level Achievement

Memberships in organizations (school-based or otherwise): Organization Membership date

Role/Position

School Awards (if any): School

Grade Level

Award

CITIZENSHIP a. Citizenship in any country and details thereof: Country Natural/Naturalized

(if naturalized, date of naturalization)

Current status

b. Petitioned as Resident or application for Residency in any other country and details thereof: Natural/Naturalized (if naturalized, date of Country Current status
naturalization)

c. Status as immigrant to any other country and details thereof: Country Date of application
(if naturalized, date of naturalization)

Current status

d. Application for naturalization in any other country and details thereof: Country Date of application Current status

WHATASPIRATIONS DO YOU HOPE TO ACHIEVE BY JOINING MISS TEEN PHILIIPINES 2014 My aspiration is to share my talents with other people and I want to notify them that dont be so arrogant if you are famous. Instead, use you fame for good reasons. xD

FAMILY BACKGROUND Name Father Mother Guardian (if any) Occupation Arthur tarun Roselyn Tarun Address Sta. Isabel sur ilagan isabela Cotabato city Contact number(s) 09163000545

If parents are separated,who has legal custody (If applicant is a minor): ________________ Is the parents separation legally documented? Yes No If parents separation is legally documented, please provide VALID ORDER OF CUSTODY

OTHER INFO Hobbies: Dancing, singing, and acting

dancing Sports/activities: Special talent(s) or skill(s): singing PARTICIPATION IN OTHER BEAUTY PAGEANTS Beauty contest/organizer Little miss mutya ng sta. Isabel sur 1st place Title Won Date

Details of all EXISTING OUTSTANDING contracts, talent management and similar agreements, sponsorships, endorsements and the like, whether written or oral, with whom entered into, and length of effectivity thereof (attach additional sheets, if necessary) Contract description With whom Length of Effectivity

Details of all PAST contracts, talent management and similar agreements, sponsorships, endorsements and the like, whether written or oral, with whom entered into, and length of effectivity thereof (attach additional sheets, if necessary) Contract description With whom Length of Effectivity

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 Role Inclusive dates

(TV show, movie, pictorial)

Note: applicant is required to disclose all present and past contracts and provide MTP organizers with a copy of media the applicant has appeared in. PERSONAL REFERENCES Name Address Contact Number(s)

CERTIFICATION, REPRESENTATION, WARRANTY AND ACKNOWLEDGMENT OF CONDITIONS 1. I/We hereby certify under oath that I/We have read the foregoing application and/or the contents of which have been explained to me/us in a language that is known to me/us; 2. I/We hereby certify that I/we have caused the completion of the foregoing Application Form; 3. I/We hereby certify that all information supplied in this Application are true and correct based on my/our knowledge and/or existing records. I/We further acknowledge that any inaccuracy, misrepresentation, false assertion, and/or error made above (as may be determined solely by the organizers) shall be a ground for the disqualification or ineligibility of the Applicant from the pageant.

4. I/We further certify that Irish Dianne Tarun (please print the name of the Applicant; hereinafter, the Applicant) understands the contents of this Application, and understand and/or represent that: o The Applicant must be 13 18 years of age on the day of the pageant. 18 years of age shall mean that the candidate must be below 19 years of age on the day of the National Pageant; o The Applicant is a natural born female o As a condition for eligibility to join the Miss Teen Philippines pageant, the Applicant must be able to provide proof of Filipino citizenship in accordance with applicable laws; o The Applicant is in good mental, physical and psychological health o The Applicant is of good moral character; o The Applicant is currently enrolled in an educational institution and shall be enrolled in such institution on the day of the national pageant or has been certified as eligible for promotion to the next higher year level; o The Applicant has not been married (whether such marriage is valid or void under existing laws) under any jurisdiction; o The Applicant has not been the subject of pornographic, scandalous, immoral, indecent, or otherwise distasteful, photograph, video, audiovisual material whether known to them or not o The Applicant has not been charged with, and/or convicted of, a crime or offense under Philippine or other laws; Affix digital signature/s above printed names of: (a) Applicant only if the Applicant is 18 years of age and above; and (b) Applicant and both parent/s (custodial parent, if separated or if parent is solo parent), or of Legal Guardian, if Applicant is a minor or below 18 years of age)] By affixing your signature below, the Applicant and/or her parents/legal guardian hereby: (a) acknowledge/s that any and all information provided herein hereby becomes the property of the organizers of the Miss Teen Philipines pageant as may be allowed under existing laws and jurisprudence; (b) authorize/s the organizers of the Miss Teen Philippines pageant to disclose to third parties any and all information stated above when deemed by them to be necessary or appropriate; (b) waive/s any cause of action that it may have or had relating to any such disclosure made; (c) hold/s the organizers of the Miss Teen Philippines pageant free and harmless from any and all claim/liability/causes of action/suits of any kind that may arise from the use of such information, including any misrepresentation made herein.] 7

Applicant: ________________________________________________________________ Legal/Valid ID:_____________________ Date/Place of Issue:________________________ Father: ___________________________________________________________________ Legal/Valid ID:_____________________ Date/Place of Issue:________________________ Mother: _________________________________________________ Legal/Valid ID:_____________________ Date/Place of Issue:________________________ Legal Guardian: __________________________________________ Legal/Valid ID:_____________________ Date/Place of Issue:________________________ Date: ___________________________________________________ SUBSCRIBED AND SWORN TO BEFORE ME this ___ day of ___________, 20__, affiants exhibiting to me their respective identification cards issued by competent authority as stated above. Doc No. _____; Page No. ____; Book No. _____; Series of ______.

DOCUMENTS TO BE SUBMITTED Attach scanned copies of the following documents: Diploma or Certificate of Enrollment in an Educational institution executed by Principal or equivalent officer Certificate of Good Moral Character given by my school or church Medical certificate for both my physical and mental health and well-being; and Documents relating to Citizenship (please check applicable citizenship category) Natural-Born Citizen Born in the Philippines Birth certificate; and Philippine passport, if applicable Balikbayan who reaquired Philippine citizenship under R.A. 9225 - Birth certificate or Report of Birth; and - Identification certificate issued by the Bureau of Immigration Natural-Born Citizen Born Outside the Philippines Report of birth issued by the Philippine consulate in the country of birth; or NSO certificate stating that birth was reported by the Philippine consulate and recorded in the Philippines