CIP Bello Model Program Application


Model Name:


Model Email Address


Model Cell Phone # 


Parent Name: 


Parent Phone #


What is your Instagram link?


What is your Facebook link? 


Which High School do you attend?


What year do you graduate?


What are some of your activities?


Why do you want to be a CIP Model?


We tailor our sessions to each individual senior.  Describe your style: 


Name 3 things that you love about yourself:


How would your friends describe you?


Name at least one celebrity that you think has AMAZING style:


Who do you look up to?


How did you hear about Captured Image Photography?


Can you think of some creative ways to help us spread the word to energize your friends to be photographed by us?


We have several events scheduled that may require participants to travel around the Kansas City area.  Are you available to travel for shoots?


I understand that being chosen as a spokes model for Captured Image Photography requires a $350 enrollment fee and will cover my photo shoots, entry into the CIP Model program, a free exclusive CIP model t-shirt, eligibility for local and national published advertising, CIP group shoot, a swag bag and VIP referral business cards.  You will be our first point of contact with the schools.  When something cool is going down, you will be the first to know!


Yes – I understand that if my application is accepted I will be required to satisfy my enrollment. 


Enrollment due by June 1st, 2015.


Model Signature  _____________________________________________________________ date ____________


Parent/Guardian Signature  ____________________________________________­­___ date ____________