SHARE MO LANG Voters' Forum | Application Form for Speakers
This is the application form for interested speakers in the SHARE MO LANG Voters' Forum to be held on April 9 (Saturday), 3pm onwards. This event is co-organized by Asian Institute of Journalism and Communication (AIJC), Break the Fake Movement, Foundation for Media Alternatives (FMA), Out of the Box Media Literacy Initiative (OOTB), Yabong Philippines, and Pinas Forward.

READ THE FULL EVENT DETAILS at https://bit.ly/SMLVOTERS
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READ FIRST: Before you proceed to answering the form, make sure that you have read the full details of the "BOTANTE AKO" forum and that you are qualified to participate in the event.
SPEAKER QUALIFICATIONS
- 18 to 35 years old
- Registered voter who is committed to voting in the May 9 elections
- Vocal and actively supports their presidential candidate of choice
- Articulate and knowledgeable of key issues in the 2022 elections
- Can commit to keeping a safe and respectful environment by avoiding name-calling and insults
- Consents to the recording and livestreaming of the event (Note: Use of pseudonym during the event is encouraged)

NOTE: Applicants will be screened based on their candidate preference, gender, regional location, and type of career and occupation. Diverse representation is priority.

DATA PRIVACY
The event organizers recognize their responsibilities under the Republic Act No. 10173 (Act), also known as the Data Privacy Act of 2012, with respect to the data they collect, record, organize, update, use, consolidate or destruct from the registrants if the event. The personal data obtained from this form is entered and stored within the organization's authorized information and communications database and will only be accessed by the respective designated officers.

The information collected and stored in the portal shall only be used for the following purpose: Processing and reporting of documents related to the registration and confirmation of participation, under certain conditions as required by law.

The organizers shall not disclose the registrants’ / delegates’ personal information without their consent and shall retain this information over a period of 5 years for the effective implementation and management of the organization's programs and initiatives in the future.

By registering through this form, you agree to the following:
1. You hereby affirm your right to be informed, object to processing, access and rectify, suspend or withdraw your personal data, and be indemnified in case of damages pursuant to the provisions of the Republic Act No. 10173 of the Philippines, Data Privacy Act of 2012 and its corresponding Implementing Rules and Regulations.

CONSENT *
Required
LAST NAME *
FIRST NAME *
AGE *
BIRTHDAY *
MM
/
DD
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YYYY
REGIONAL LOCATION *
Which of the following most accurately describe(s) you? (Check all that apply) *
Required
Mobile phone number *
Link to your personal Facebook page *
The application process includes a quick social media check for verification purposes. Please provide the link to your FB page/account below (e.g. https://www.facebook.com/ootbmedialiteracy)
Are you a registered voter? *
Are you voting in the May 9 national elections? *
Who among the presidential candidates are you voting for? *
If any, who among the presidential candidates is your second choice? (OPTIONAL)
Clear selection
If any, who among the presidential candidates are you campaigning against (the candidate/s that you do NOT want to win)? (OPTIONAL; Check all that apply)
Are you campaigning for your presidential candidate? *
Which electoral campaign activities are you engaged in? (Check all that apply) *
Required
EMPLOYMENT STATUS *
If currently a student, what is your year level, degree program, and school?
OCCUPATION TYPE *
CAREER CLASSIFICATION *
Job Title *
Employer / Company affiliation (OPTIONAL)
Which issues are you most concerned with? (Check all that apply) *
Required
A copy of your responses will be emailed to the address you provided.
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