MEDIANINE MODEL INFORMATION
The following answers are requested to help us provide a safe and comfortable
working environment for everyone.
List/describe any piercings:
List/describe any tattoos:
Do you wear contact lenses?
Do you smoke?
List/describe any allergies (smoke, animals, food, latex, etc):
List/describe any health problems or physical limitations (back/neck
problems, bad knees, recent surgeries, etc):
List/describe any phobias/fears: (claustrophobia, fear of clowns/bugs, squeamish
LEGAL INFORMATION (The following information to be provided upon hire)
Your legal name will not be used in publication. Legal name, address,
phone number and other personal information is confidential and will not be
released to any persons or organizations not connected with MediaNine unless
compelled to by a lawful authority.
Full Legal Name:
Date of Birth
Social Security Number