* Required
This contest is only open to females.
*First Name:
*Last Name:
*Date of Birth:
*E-mail Address:
*Street Address:
*City:
*State: Select if in USA Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Not Applicable Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
*Zip Code:
*Country: United States Canada Afghanistan Albania Algeria Andorra Angola Argentina Antartica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bharain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Gibraltar Greece Greenland Grenada Grenadines Guadelope Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, People's Republic Korea, ROK Kuwait Kyrgyzstan Lao Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriyah Liechtenstein Lithuania Luxembourg Macau Macedonia Madagaskar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova, Rep. of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Rep. of Panama Papua New Guinea Paraguay People's Rep. China Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Samoa Rep. San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Rep. of Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, ROC Tajikstan Tanzania Thailand Togo Tokelau Tonga Trinidad West Indies Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine UAE United Kingdom Uruguay US Virgin Islands Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
*Primary Phone Number: Primary Phone Type: Cell Home Work
*Alternate Phone Number: Alternate Phone Type: Cell Home Work
Represented: Yes No
If Yes, By Whom?
Training/Experience (when/where):
Are you currently in another contest? If yes, Explain:
Parent/Guardian Name:
Parent's Phone Number:
Parent's Height:
DISCLAIMER: Applying models must be at least 5’6 if still growing and at least 5’7 if adult
Height: ---- Select ---- 5' 6" 5' 6.5" 5' 7" 5' 7.5" 5' 8" 5' 8.5" 5' 9" 5' 9.5" 5' 10" 5' 10.5" 5' 11" 5' 11.5" 6' 0" 6' 0.5" 6' 1" 6' 1.5" 6' 2" 6' 2.5" 6' 3" 6' 3.5" 6' 4" 6' 4.5" 6' 5" 6' 5.5"
Bust: ---- Select ---- 24.5" 25" 25.5" 26" 26.5" 27" 27.5" 28" 28.5" 29" 29.5" 30" 30.5" 31" 31.5" 32" 32.5" 33" 33.5" 34" 34.5" 35" 35.5" 36" 36.5" 37" 37.5" 38" 38.5" 39" 39.5" 40" 40.5" 41" 41.5" 42"
Cup: ---- Select ---- A B C D DD
Waist: ---- Select ---- 15.5" 16" 16.5" 17" 17.5" 18" 18.5" 19" 19.5" 20" 20.5" 21" 21.5" 22" 22.5" 23" 23.5" 24" 24.5" 25" 25.5" 26" 26.5" 27" 27.5" 28" 28.5" 29" 29.5" 30" 30.5" 31" 32" 33" 34" 35" 36" 37" 38" 39" 40"
Hips: ---- Select ---- 24.5" 25" 25.5" 26" 26.5" 27" 27.5" 28" 28.5" 29" 29.5" 30" 30.5" 31" 31.5" 32" 32.5" 33" 33.5" 34" 34.5" 35" 35.5" 36" 36.5" 37" 37.5" 38" 38.5" 39" 39.5" 40" 40.5" 41" 41.5" 42" 42.5" 43" 43.5" 44" 44.5" 45" 45.5" 46" 46.5" 47" 47.5" 48" 48.5" 49" 49.5" 50"
Dress: ---- Select ---- 0 2 4 6 8 10 12 14 16 18
Shoes: ---- Select ---- 4 4.5 5 5.5 6 6.5 7 7.5 8 8.5 9 9.5 10 10.5 11 11.5 12 12.5 13 13.5 14 14.5
Hair: ---- Select ---- Blonde Brown Light Brown Dark Brown Black Red Auburn Platinum Salt & Pepper Gray Bald White Dark Blonde Light Blonde Strawberry Blonde Shaved
Eyes: ---- Select ---- Blue Green Blue-Green Gray Blue-Gray Black Brown Hazel Dark Brown Gray-Green
Guidelines For Taking Snap shots (make sure to follow these exactly when taking your snapshots):
Positions
Image 1:
Image 2:
Image 3:
Image 4:
Image 5:
Image 6:
Image 7:
Image 8:
Image 9:
Official Model Search Rules 1. How to enter: Fill out this form. Completed entries must be received by January 15th 2012. Incomplete forms will not be accepted. All entry information must be clearly and legibly typed. All submissions become the property of Factor Women Model Management and will not be returned. 2. Eligibility: All submitting models must be at least 13 years of age. All under age models must avert their parents of their submission. Applying models cannot be part of any other modeling contest. If signed with another agency the applying model must specify which agency this is. 3. Judging Process: A panel of celebrity judges, and Factor Women team will review all submissions and select finalists on the basis of overall appearance and photogenic qualities. The finalists will be chosen by February 1st 2012 and notified by phone/e-mail and will be required to send additional photos and make a two-minute video on why they should be the next Factor Model. Voting will then be open to the public, as well as the VIP judges. Public votes will count for 33% and judges' votes will count for 67% of total. 4. Winner Selection / Prizes: Depending on the applying models’ potential One winner and possibly several runner ups will be selected. Prizes for the winner will include: 1. A general modeling contract with Factor Women Model Management (terms to be defined upon winning). 2. Winner receives an editorial photo shoot for a fashion magazine. 3. One photo shoot – for the models’ portfolio. 4. A gift certificate. 5. Professional style and makeup consultation with Looks Salon? 6. Runners up will be awarded a modeling contract and a gift certificate. 5. General: Entrants agree to be bound by these rules and the decisions of the judges, which are final in all respects. All winners will be required to execute, without change, standard model agreements in the contract prepared by Factor Women Model Management. 6. No purchase is necessary to be eligible for the contest.
I have read and accept the contest rules & regulations