OFFICIAL ENTRY FORMMedium: Pastel on Board Paper Acrylic on CanvassName: _______________________________________________________________________ Surname First Name MIComplete Residential Address: _______________________________________________________________________________________________________________________________Tel. No._________________ Mobile No.: _________________ Email: ____________________Age: ____ Gender: ____ Date of Birth: _________ Place of Birth: ___________ Status: ______School Background:College/University: ____________________________Course: _______________ Year: ______Are you a member of any art group?o Yes (Please indicate the name)_______________________________________________o NoHow did you learn of the competition? (You may specify more than one)o Poster o Art Groupo Fellow Artist (word of mouth) o Facebooko Flyers o Email invitationo Information Campaign o Others (please specify) _____________I hereby swear to the truth of the foregoing information and that I have read and understood andwill abide by the rules of the competition.
______________________________________________ ENTRY NO.: Artist’s Signature over Printed Name 2 by 2 PhotoData On The PaintingTitle of Painting: _______________________________________________________________________________Medium/ Materials used: ____________________________________________o Pastel on Board Papero Acrylic on CanvassDate Painting was Started: _________________________ Date Completed: _________________________Please answer the following questions as briefly as you can (You may answer in Filipino):1. What is your concept of hog raising in the Philippines?Before doing this artwork:_________________________________________________________________________________________________________________________________________________________________________________________________________________After doing this artwork:_________________________________________________________________________________________________________________________________________________________________________________________________________________2. What is the main message of your artwork?_________________________________________________________________________________________________________________________________________________________________________________________________________________3. How does your painting inspire the industry of hog raising?_________________________________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________Artist’s Signature over Printed Name AFFIDAVITI,__________________________________, Filipino, ______ years old, single/married and residing at_____________________________________________________________ after having been duly swornin accordance with the law, hereby depose and state that:1. I am joining PIGtacular Nationwide Painting Competition and in connection therewith, I am submittingas my official entry, the painting entitled “_________________________________,” hereinafter called the“ENTRY”.2. The ENTRY is my original and exclusive creation, being the result of my intellect and labor alone, andhas not been copied from nor is similar to any previous or existing artwork (painting, design, sketch,photograph, etc.) in terms of composition or otherwise, even if rendered in a different style, medium orcolor scheme.3. The decision of the Board of Judges as to whether my ENTRY is original shall be final and I bindmyself to abide by said decision.4. I began work on the above-stated ENTRY on ______________________ and completed and readiedthe same for competition on ___________________.5. I unconditionally consent to the use of my winning entry for any UNAHCO material such as wallcalendar, desk calendar, planner, address book, all-occasion cards, e-cards, and other products/items,and media without liability on the part of, or cost or fee to be paid by UNAHCO.6. If I fail to claim my ENTRY on the dates specified in the rules, then I agree that it shall automaticallybecome the property of Petron Corporation.7. I have read and I will abide by the rules, regulations and requirements governing the above mentionedcompetition and, in this regard, I hereby exempt, discharge, release and free UNAHCO and itsdirectors/trustees/officers and staff and shall defend and hold them free and harmless from any claim,liability or legal action arising from any potential or actual loss or damage arising from breach or falsity ofany of my representations, acceptances or undertakings herein and from any claim or liability from anyloss or damage which my ENTRY may suffer while being transported or while otherwise in the custody ofthe UNAHCO.I am executing this affidavit to attest to the truth, veracity and validity of all the foregoing and to certify,under oath, originality, authenticity, and ownership of my above mentioned ENTRY, under pain of perjury.In witness whereof, I have hereunto set my hand this __________ day of ____________________ 2012,in the City/ Province of ____________________.______________________________ AFFIANTREPUBLIC OF THE PHILIPPINESSUBMITTED AND SWORN TO before me this _______ day of _____________ 20 _________, in_____________, affiant exhibiting his/her Community Tax Certificate No. ___________Issue at
________________ on _________, 20 ________.Doc. No. ______________Page No. ______________Series of 2012