YOUR NAME?

         First name:     

         Middle name: 

         Last name:     

         Title:         Choose one Miss Mrs Ms. Mr Master Other

          Preferred nickname or professional name:   (If applicable)

         WHAT AREA DO YOU LIVE IN?

         Town:          County:  

        AGE:

          What is your age:   years

          Date of birth:    Day: 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31     Month: 00 01 02 03 04 05 06 07 08 09 10 11 12     Year: 0000 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940

        CONTACT DETAILS?

           Home telephone:  inc. STD code

           Work telephone:   inc. STD code  (only req. if it can be used as a contact number)

           Mobile:    

           E-mail address: 

          Confirm E-mail address: 

          Web Address URL: 

        ABOUT THE AGENCIES YOU ARE REGISTERED WITH?

          1st agency name:    Telephone number:

          1st agency other info:

          2nd agency name:     Telephone number:

          2nd agency other info:

          3rd agency name:     Telephone number:

          3rd agency other info:

        PREFERRED METHODS OF CONTACT FOR ME TO USE?

          Select as many options as you wish as your preferred method by which I can contact you.

Home Phone     Work Phone     Mobile    

E-mail     Web site    Other ..... specify >

Via agency one     Via agency two     Via agency three

   

        PHYSICAL DETAILS?  Please specify ins, cms etc.

             Complexion: Choose one Light Fair Dark Tanned             Other complexion:

          Eye colour:   Choose one Blue Brown Hazel Grey Green              Other eye colour:

          Hair colour:   Choose one Light_Blonde Dark_Blonde Ash_Blonde Brunette Light_Brown Dark_Brown Auburn Red Black            Other hair colour:

          Hair Highlights  Yes     No

          Height:  

          Bust:  

          Waist:  

          Hips:     

          Dress size:  

          Shoe size:     

          Outside leg:   if known.

          Glove size:   if known.

          Hat size:     if known.

        HOBBIES, INTERESTS, TALENTS?

        DISTINGUISHING MARKS OR FEATURES? ( inc. tattoos, body piercing etc.)

 

OCCUPATION?

Full time model     Part time model .................

..........if part time please state main occupation >

 

        WHAT LOCATIONS ARE YOU WILLING TO WORK IN?

          (Select all that apply.)

Indoor (Studio/Set)     Outdoor locations

  Any location     Other.....specify >

 

WHERE ARE YOU PREPARED TO TRAVEL?

(Select all that apply.)

UK Mainland     UK Anywhere     Europe     International

Local only...within the following radius > Choose one 5 miles 10 miles 15 miles 20 miles 25 miles 30 miles 35 miles 40 miles 45 miles 50 miles 60 miles 70 miles 80 miles 90 miles 100 miles

 

        WHEN ARE YOU AVAILABLE?

        (Select all that apply.)

Weekdays     Evenings     Weekends     Bank holidays

Anytime     Other.....specify >

 

        WHAT TYPES OF MODELING ARE YOU PREPARED TO DO?

          (Select all that apply.)

Portraiture     Fashion     Accessories     Sportswear     Swimwear     Makeup 

Fancy dress      Lingerie     Glamour     Catwalk     Exhibitions/Promotions

Semi-Nude life study      Nude life study  

Other.....specify>

 

RATES OF PAY?

If you have specific rates of pay that you require, and you are taking work on your own behalf, then you may enter them here. 

Please note that if your preferred method of contact is an agency then they will normally negotiate rates, with the client, on your behalf.

 

PREVIOUS MODELING EXPERIENCE? (Brief details only)

 

ANY OTHER COMMENTS?

 

Have I photographed you within the last twelve months?

Yes     No  

Please Note: If you have answered no to this question you should send  me at least one picture by separate email or give details of a web site where I may view your picture.

Thank you for taking time to fill in the form.

 

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