Model Application - PlanetPlugged.com

Model Application

Please fill out ALL information in the form below.
If there are any questions that DO NOT apply to you, then enter NONE.

For ALL items you mark as other, please explain in the comment section.
If a field does NOT contain your info, place it in the comments also.

This is especially important for stats.

Your Name (for the return email)

Your Email address (for return email)

In filling out this form, are you requesting that you be considered for representation by PlanetPlugged.com and/or its subsidiaries?

Yes No

Contact Information

First Name

Last Name

Alias or Stage Name (IF ANY)

Email Address

Street Address

Street Address(additional)

Mailing Address (if different)

Mailing Address (additional)

City State
Zip
Country

Please include Area Code with all Phone Numbers.
(Use this format: 123-456-7890)

Home Phone Work Phone Cell Phone Pager

List any Other ways to Contact you for Assignments (if any)
(i.e. Fax Numbers, Friends, Relatives, etc.)

Personal Statistics

Age Date of Birth
(MM-DD-YYYY) Nationality If Mixed, please list nationalities

- -

Hair Color Hair Length Eye Color

Skin Tone or Color Height Weight

MEASUREMENTS

Bust Size Waist Hips

Dress Size Shoe Size Glove Size(if known)

What age range can you look?
(i.e. 15-50)

Describe Any Tattoos:
(and their location)

Describe Any Body Piercings:
(to include ears)

List any Cosmetic Surgery or Scars
(Including Breast Augmentation):

Best Feature(s)

Additional Personal Information

Occupation

Marital Status (i.e. husband/wife, boyfriend/girlfriend, etc.)

Personal Web Site URL (if you have one)

List any Other Personal Info that could affect your ability to take an assignment:
(i.e. children, parents, allergies, lack of transportation, etc.)

Comments:

Work Related Information

Types of Modeling or Work you will do: (Check all that apply)
The more flexible you will be, the more paying work we can find for you.

Runway Casual Wear Print Ad Calendar

Editorial Internet Publication Convention Electronic Imaging

Art (Topless) Implied Nudity Beauty Glamour (Fashion)

Product Joint Ventures (Photographer/ Model) Swimwear/Bikini All of the above

Are you willing to do "prints for time" test shoots?

Yes No

Compensation you are willing to work for:
(Select ALL that apply)

Prints Computer Scans Tear Sheets Promotion

Free Webspace Pay Negotiable Any

Are you willing to travel for assignments, auditions and/or test shoots?

Yes No Only with expenses paid

Experience Level:

Do you have an up-to-date Portfolio?

Yes No

If it is not current, what additional Images/Looks do you need or want?:
(Check all that apply)

Other Looks: (describe)

List any Past Modeling, Acting, Pageant or Contest Projects or Schools

List any Interests and Hobbies that might help you with a shoot

By submitting this form I state that I am at least 18 years old. I am aware that submission of this application in NO WAY obligates PlanetPlugged.com and/or its subsidiaries to offer me a contract.

After all of the categories have been filled to the best of your abilities please hit the submit button. Only hit the submit button ONCE! The form is being submitted by email.

Once you complete and submit the above form you will taken to a page that has a link
where you can email your pictures or obtain information to send us pictures via snail mail.

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