Registration form copy

REGISTRATION NO.
AUDITION DATE
SM LITTLE STARS 2016
REGISTRATION FORM
PREFERRED MALL
(PLEASE WRITE IN PRINT AND USE BLACK INK ONLY)
CHILD INFORMATION
GIVEN NAME
SURNAME
GENDER
MALE
DATE OF BIRTH
m
FEMALE
m
d
M.I.
PLACE OF BIRTH
d
y
NICKNAME
AGE
HEIGHT
WEIGHT
y
ADDRESS (NO. & STREET, CITY/TOWN & PROVINCE)
HOBBIES/SPECIAL TALENTS
SCHOOL & SCHOOL ADDRESS
REASON FOR JOINING SM LITTLE STARS 2016
AMBITION
CONTEST/S PREVIOUSLY JOINED (INDICATE THE YEAR)
PARENT/GUARDIAN INFORMATION
MOTHER’S FULL NAME
FATHER’S FULL NAME
COMPANY NAME/BUSINESS ADDRESS
COMPANY NAME/BUSINESS ADDRESS
MOBILE NUMBER
MOBILE NUMBER
EMAIL ADDRESS
EMAIL ADDRESS
GUARDIAN’S FULL NAME
MOBILE NUMBER
RELATIONSHIP TO THE CHILD
I hereby certify that all the provided
information here are true and correct and
that any false information shall be sufficient
ground for disqualification from the contest.
ADDITIONAL INFORMATION
HOW DID YOU LEARN ABOUT SM LITTLE STARS 2016?
SOCIAL MEDIA/
WEBSITE
TV
RADIO
NEWSPAPER
SIGNATURE OVER PRINTED NAME OF
PARENT/ GUARDIAN/ DATE
OTHERS
SM LITTLE STARS 2016
(To be filled up by SM Marketing Personnel Only)
Contestant’s Name:
Parent’s / Guardian’s Name:
Receiving Mall Branch:
Received By:
Registration No.: