1. CAST
MEMBER’S INFORMATION
Batch Name: Revival Batch
2” x 2”
Date of Entry: September 30, 2010 photo
Name ___________________________________________
Surname Given Name Middle Name
Nickname ___________________ Birthday _____________
Student No. _________________ Degree Course ____________ Year Level __________
E-mail Address ___________________________ Cell Phone No. ___________________
Home Address ___________________________________________________________
___________________________________________________________
_____________________________ Phone No. ____________________
Campus Address ___________________________________________________________
___________________________________________________________
_____________________________ Phone No. ____________________
Interest(s) [check all that apply]
 Theater  Voice  Literature [specify:
________________ ]
 Film  Instrument(s) [specify:
_________________ ]  Visual Arts [specify:
 Dance
_________________ ]
 Others:____________
__________________
Special Skills ____________________________________________________________
____________________________________________________________
Other Organizations ________________________________________________________
________________________________________________________
Member’s Signature over Printed Name
Date