MUPH 2021 Accredited Partner Form

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

ACCREDITED PARTNER APPLICATION FORM

PERSONAL INFORMATION

NAME
(Last Name) (First Name) (Middle Name)

ADDRESS

DATE OF BIRTH PLACE OF BIRTH


CITIZENSHIP EMAIL ADDRESS
PHONE NUMBER MOBILE NUMBER PHOTO

PRESENT OCCUPATION TIN NUMBER


EMPLOYER / NATURE OF BUSINESS
(indicate if self-employed)

SOCIAL MEDIA ACCOUNTS


FACEBOOK
INSTAGRAM
TWITTER

DATA OF SUPPORT ORGANIZATION, if applicable


NAME OF ORGANIZATION
SEC/DTI REGISTRATION NUMBER, if applicable
POSITION IN ORGANIZATION
ADDRESS

WEBSITE EMAIL ADDRESS


PHONE NUMBER MOBILE NUMBER

ATTACHMENTS

1. Letter addressed to the National Director, expressing intent to be an accredited partner, establishing residency or strong
connection to the locality to be represented, and citing experiences in pageantry or related industries;
2. Curriculum Vitae;
3. Image of the first page of passport, if there is any; and
4. NBI clearance.

DATA PRIVACY NOTICE

I have read this form and understand its content and voluntarily give my consent for the collection, use, processing, storage and
retention of my personal data or information to Miss Universe Philippines (MUPh, Inc.) for the purpose of my application to be an
Accredited Partner (AP). I also understand that my consent does not prevent the existence of other criteria for lawful processing of
personal data under RA 10173 – Data Privacy Act of 2012 and other applicable laws and regulations.

REPRESENTATIONS AND WARRANTIES

By affixing my signature below, I represent and warrant that all information that I provide or have provided are true and correct to the
best of my knowledge, and freely and voluntarily given for purposes of allowing MUPH to determine my eligibility to be an AP for
_________________________ Province/City for the 2021 Pageant.

I also represent and warrant that, as Accredited Partner, I will be responsible for the overall welfare of my candidate, including her
financial requirements as candidate of MUPh 2021.

Applicant’s Signature over Printed Name Date

You might also like