SECTION 1

First Name

Last Name

Birthdate: day/mnth/yr

E-mail

Contact Phone # (---) --- ---

Alternate Phone # (not required)

Mailing Address

Street: Apt. #: Box #: State: Zip code:

SECTION 2

Have you applied with us before?

Yes
No

How did you hear about us?

Through a friend
Internet
other

Education

G.E.D.
High School Diploma
Some College
Currently Enrolled
College Graduate

Modeling/Entertainment Experience?

None
Less than 6 months
More than 6 months, Less than a yr.
1 yr or more

Are you currently employed?

No
Yes/ part-time
Yes/ full-time

Work Shifts: (most often, if employed)

Mornings/Days
Evenings
Nights/Graveyard

Are you currently on probation?

Yes
No

SECTION 3

Position you're applying for?

Part-model
Full-time model
Public Entertainer
Private Entertainer

Taste Request: (check all that apply)

non-nude photos only
non-nude photos/video
Partial-nude photos: bakini, lingerie, etc.
Partial-nude photos/video
Nude photos only
Nude photos/video
Non-nude display ( stage show)
Partial-nude display
Nude display

Are you able to perform the essential functions of the job position with or without complete accommodations?

Yes
No

If "No", explain request(s):

Shifts Desired, if hired.

Mornings/Days
Evenings
Nights/Overnights
Swing Shifts

Date you can become active if hired?

SECTION 4

Emergency Contact Name:

Relation to Contact?

(step) Father/Father-in-law
(step) Mother/Mother-in-law
Uncle/Aunt
Friend/Girlfriend/Boyfriend
Husband/Wife/Fiance
Brother/Sister ( in-law)
Son/Daughter
Grandma/Grandpa
(other)

Address of Relation

Street: Apt.#: Box #: State: Zip code:

Alternate Emergency Contact #? (not required)

SECTION 5

Note: All applications will be kept on file for at least 6 months before being deleted.

I understand that this is only an "Endorsement Agreement" application and will not validate any official Beauty of Modeling Inc. Pro-Amateur Contract.

Questions/Comments/Additional Info.

I agree in good and equal faith that the information given in this application is to the best of my knowledge accurate and true; and in accordance with KBM&E policy will be kept private and not be shared, loaned, traded or revealed to any party outside of BKC/KBM&E, including government/law enforcement officials without applicant's consent or consent of applicant's legal representative or proper legal documents.

E-Signature: (your name)

Date: day/mnth/yr

E-Signature: KBM&E Inc. (2010)