So, I have copied it and am posting it below for you to enjoy (I am not putting in my answers, because I don't want you to know THAT much about me yet):
UNTITLED MAJOR NETWORK TELEVISON SHOW
Please be sure to read the Eligibility Requirements and the Release and Waiver at the end of this document before completing this application. The Eligibility Requirements and the Release and Waiver contain important information and terms which must be met in order to proceed with the application process for a program currently entitled “Untitled Major Network Television Show” (the "Program"). In addition, please remember, above all else, you must be honest on the application! Any answer may be verified for accuracy.
1.) First Name _______________Middle Name_____________Last Name_________________
2.) Have you ever formally or otherwise changed your name or used an alias or another name? If so, what other names and/or aliases have you used?
3.) Are you: Male _______________ Female ______________
4.) Age ______________ Date of Birth _______/_____/_______
PLEASE NOTE: Applicants must be at least 18 years of age at the time of this application
5.) Height ______________ Weight ______________ Ethnicity ________________
6.) Social Security # ______-_____-______ Driver’s License # _________________
7.) Are you a United States citizen? Yes/No
Are you a permanent legal resident of the U.S.?
Do you have a current United States passport? Yes/No
If yes, expiration date: _____________
8.) Home Street Address __________________________________________________
City _____________________ State ________ Zip code ___________
Permanent Address ____________________________________________________
City _____________________ State ________ Zip code ____________
9.) Not including your current place of residence, in which other cities and/or countries have you lived and for what period of time? Why did you live in each such city or country?
10.) Phone (Daytime) _________________ Phone (Evening) ____________________
Cellular (If any) __________________ Pager (If any) ______________________
11.) E-mail Address (If you don't have one, tell us why you don't.)
12.) Name, Phone Number, and Address of Closest Friend
13.) Name, Phone Number, and Address of Nearest Relative
14.) Name and Phone Number of an Emergency Contact and relationship to you
15.) Do you have a homepage, facebook, myspace, twitter, or other social media site on the Internet? If so, what is the address?
16.) Marital Status (Circle one of (a) through (h) and answer each of the accompanying questions as applicable)
How long? _____________
How long? ____________ How many times? _________
How long? ____________ How many times? _________
(e) NOT MARRIED, BUT LIVE W/ SIGNIFICANT OTHER
How long? _____________
How long? _____________
How long? _____________ How many times? _______ _
How long? _____________
17.) If you are married or in a relationship, how would you rate your relationship on a scale of 1-10? Please explain.
18.) If you are married or in a relationship, how will your partner feel about you being on television?
19.) What is the highest level of education you’ve completed? (Circle one)
(a) NO SCHOOLING
(b) HIGH SCHOOL (Diploma? ____________ or GED? _________)
(c) ASSOCIATE COLLEGE DEGREE
(d) BACHELOR'S COLLEGE DEGREE
(e) MASTER'S COLLEGE DEGREE
(f) PROFESSIONAL OR DOCTORAL DEGREE
20.) What school(s) did you attend? (Include the city, state, and year)
21.) Are you a professional performer within the entertainment industry? If so, what do you do?
22.) Do you have any acting, singing or performing aspirations? If so, tell us your wishes and goals.
23.) Have you ever appeared on television? If so, in what capacity did you appear and when? Did you appear on national television?
24.) Have you ever appeared in any magazines? If so, which magazine and in which issue?
25.) Have you ever been represented by a manager or agent? If so, please specify when and what the representation covered (e.g., modeling, acting, or hosting).
26.) Are you currently represented by an agent or manager? If so, please specify what the representation covers (e.g., modeling, acting, or hosting).
27.) Have you ever been arrested? If so, tell us about it (include dates, city & state).
28.) Have you ever been charged with a crime? If so, tell us about it (include dates, city & state).
29.) Have you ever been convicted of a crime? If so, tell us about it (include dates, city & state).
30.) Have you ever had a restraining order issued against you? If so, tell us about it (include dates, city & state).
31.) Have you ever had a restraining order issued against someone else? If so, tell us about it (include dates, city & state).
32.) Are you involved in any pending litigation? If so, tell us about it (include dates).
33.) Are you, or have you ever been a candidate for public office?
33b.) I have listed below, to the best of my knowledge, (i) anyone I know or have known (including myself) who has now, or has been in the past two years, an officer, employee, agent or representative of any television network, Upper Ground Enterprises, Inc., ITV Studios, Inc. and/or any of their respective licensees, assignees, partners, parents, or affiliated or subsidiary companies, and (ii) the titles, jobs, and/or functions such persons have held or occupied:
34.) Do you have any children? If so, please list their name(s) and age(s).
35.) Regardless of your marital status, describe your ideal romantic partner.
36.) Describe your relationship with your mother.
37.) Describe your relationship with your father.
38.) What is your current occupation?
39.) Do you enjoy your job?
40.) Have you had any particularly interesting occupations in your past?
41.) List the last three jobs you have held, a short description, and the length of time at each job.
42.) Are you a student? If so, tell us about your major or course of study and your school name.
43.) Do you smoke? If so, what do you smoke and how often?
44.) Do you drink alcohol? If so, how often do you drink and how much?
45.) How often do you get drunk? How do you act when you get drunk?
46.) What are your thoughts on religion?
47.) Are politics important to you? How often do you vote?
48.) Are you a vegetarian? Do you have any food limitations (e.g. allergies, religious, etc.)?
49.) What kind of music do you like best?
50.) What magazines do you read?
51.) Do you belong to any affiliations or organizations?
52.) Do you have any body art (piercings, tattoos, etc.)? If so, please describe them.
53.) Name three of your favorite hobbies:
54.) Do you consider yourself shy or outgoing?
55.) Are you vocal, or do you try to “mind your own business?”
56.) Do you have a lot of friends? Mostly men, women, or both?
57.) Are you able to commit to a decision? Are you a commitment-phobe?
58.) Do you procrastinate, or take on tasks as soon as possible?
59.) Are you an organized person?
60.) Do you consider yourself to be a leader? Do you work well with others?
61.) Are you usually the center of attention? If so, does that bother you, or do you thrive on it?
62.) Do you always have to be right? Will you argue if you think someone else is wrong?
63.) Do you care about how other people perceive you? Does their opinion matter?
64.) Are you a sensitive or emotional person?
65.) Do you take what other people say about you personally?
66.) Do you wear your emotions on your sleeve?
67.) Do you have a tough time dealing with criticism?
68.) Are you a good problem solver? Do other people come to you for advice?
69.) Are you confident in the advice that you give other people?
70.) Do you consider yourself a “wild card,” or are you more “by the book?”
71.) Do you consider yourself to be a good listener?
72.) Are you an aggressive, passive, or passive-aggressive person? Why?
73.) How do you usually react if someone starts telling you what to do?
74.) Are you trusting of other people? Is there a specific person you trust completely?
75.) Do you accept what you hear as the truth, or do you think that most people have something to hide?
76.) Are you a people-pleaser? Do you find yourself apologizing a lot?
77.) Do you believe in “paying it forward?”
78.) Have you ever been discriminated against? Please explain.
79.) Do you usually follow your gut instinct, or do you ask for assistance and advice?
80.) If you could sum up your life story in three words, what would they be?
81.) Have you been treated for any serious physical or mental illnesses within the last five (5) years? (Circle one)
82.) If you answered "yes" in Question 81, please describe in detail, indicating dates, diagnoses and any ongoing treatments or difficulties.
83.) Have you ever visited a therapist, psychologist, psychiatrist, etc.? If so, when, where, and for what reason?
84.) Please list any allergies you have (medications, food, hay fever, dust, etc.) and your current treatment for them (if any).
85.) Have you ever been diagnosed with, or treated for, alcoholism or any other drug-related addiction? If so, please provide more details, including how long you've been in recovery, if that's the case.
86.) Are you currently taking any medications? Please give medication, dosage, and length of time on the medications.
87.) Do you have a temper? How often do you lose your temper? What provokes you?
88.) How do you deal with anger?
89.) How do you deal with someone who intimidates you?
90.) When was the last time you hit, punched, kicked, or threw something in anger? Please provide details.
91.) What life-changing decision are you currently facing?
92.) Why haven’t you been able to make your decision yet?
93.) How long have you been thinking over the decision?
94.) Is there a certain date by which you have to make this decision?
95.) What are the possible outcomes/consequences of your decision?
96.) Why are you having such a hard time with this decision?
97.) Has anyone in your life taken a firm position on what you should do? If so, who? And what are their thoughts?
98.) Have you ever had to make a decision like this in the past?
99.) Are you normally cautious, or impetuous in your decision-making process?
100.) Is there someone else whom your decision may affect? What is your relation to them, and what do they stand to lose/gain?
101.) List three adjectives that best describe you.
102.) If you could hold any political office, what would it be and why?
103.) What is the accomplishment you are most proud of?
104.) What are you most ashamed of, either now or in your past?
105.) Describe your perfect day.
106.) Who is your hero and why?
107.) Finish this sentence: "My life's motto is…"
108.) Do you want to be famous?
109.) What would you do if this show made you famous?
110.) If you could throw a surprise party to honor someone in your life that is deserving, who would it be and why does this person deserve to be honored?
111.) What would irritate you about people giving you advice or their opinions?
112.) What do you think would be the most difficult part of appearing on television? Explain.
113.) What do you hope to gain from being on the show?
114.) Is there anything else you'd like to tell us about yourself and why you think you'd make a great participant for this show? Try to differentiate yourself and be creative!
115.) Have you ever applied for and/or appeared on any other reality TV shows, dating shows or game shows?
116.) How did you hear about the show?
1. You must be at least 18 years of age.
2. You must be either a US citizen or a permanent legal resident and a resident of the State of California.
3. You must not be a candidate for public office and must agree not to become one until after one (1) year after the initial broadcast of the episodes of the Program in which you appear, if selected as a participant.
4. You may not participate in the Program if your participation would create impropriety or the appearance of impropriety. In making this determination, Upper Ground Enterprises Inc. (“Producer”) will consider whether you or any member of your immediate family or anyone living in your household is or has been within the last two (2) years an employee, officer, director or agent of any of the following:
(a) Any television production company, network, station or distributor that exhibits or distributes the show;
(b) Producer, or any other person or entity any person or entity involved in the development, production, distribution or other exploitation of the reality-based program currently entitled “Untitled Major Network Television Show” (the “Program”) or any variation thereof;
(c) Any sponsor of the Program or its advertising agency; or
(d) Any person or entity supplying prizes or other services to the Program.
In addition, Producer reserves the right to render ineligible any person whom Producer determines, in its sole discretion, is sufficiently connected with the production, administration, judging, or distribution of the Program, such that his or her participation in the Program could create the appearance of impropriety.
5. If selected as a participant you must execute waivers and release agreements required by Producer or any of its licensees, successors or assigns.
6. You will need to be available to the production for approximately one (1) week in January 2012 for finalist call backs and for approximately two (2) weeks in February 2012 for production of the Program and be willing to travel to various locations as part of production. Dates subject to change at any time.
7. You must be willing to submit medical information to the production, and you must be willing to submit to a medical examination, psychological examination, and background check. Any offer to become a participant is conditioned upon your submission to such examinations and investigations to be conducted by professionals selected by and paid for by the Producers, the certification of the medical professionals that you meet all physical and psychological requirements and the approval by Producer of the results of the background check.
8) Being chosen to interview at any level will not ensure that you will be selected to continue through the selection process. Producers reserve the right to disqualify or exclude, at their sole discretion any individual from the interview and selection process at any time. Producers also reserve the right to change the rules and procedures at any time.
RELEASE AND WAIVER
I hereby acknowledge that: (i) I understand, satisfy, and agree to be bound by, the eligibility requirements for UNTITLED MAJOR NETWORK TELEVISION SHOW (the “Program”); (ii) I have answered and will answer all questions posed to me honestly and accurately; (iii) if any of the information that I have provided or will provide is found to be false or incomplete, it may be grounds for dismissal from the Program selection process, and/or my being dismissed as a Program participant, if previously selected as a participant; (iv) even if I meet the eligibility requirements, any programming service which exhibits and/or distributes the Program (the "Network"), Producer and/or any of their respective licensees, assignees, partners, parents, or affiliated or subsidiary companies have no obligation to conduct any initial and/or follow-up interview with me, and/or select me as a participant; (v) even if I am selected as a participant, the Producer has no obligation to produce the Program and the Network has no obligation to broadcast it, even if it is produced; (vi) in the event that the show is cancelled, or not broadcast for any reason, the Producer has no obligation to award any prize money; (vii) all of Producer's decisions concerning selection of the participants, the elimination of participants on the Program and winners in the Program are final and not subject to challenge or appeal; and (viii) the Producer shall own and shall have no obligation to return or maintain any materials submitted as part of my application whether or not I am or am not selected as a participant.
By submitting this application, I hereby consent to the recording, use and reuse by Producer of my voice (including, without limitation, my speaking and singing voices), actions, likeness, name, appearance and biographical material (i.e., collectively “Likeness”) in any and all media now known or hereafter devised, worldwide in perpetuity, in or in connection with the Program and the promotion and exploitation (in any form or media) thereof. I agree that Producer may use all or any part of my Likeness, and may alter or modify it regardless of whether or not I am recognizable. I further agree that the Producer exclusively owns any application materials (videos, photos, etc.) that I may have provided in connection with my application for or participation in the Program and any photos, video or recordings of any kind that Producer will make of me in connection with the Program and my application therefore (collectively, the “Materials”) and all rights therein and thereto including, without limitation, the right to use the Materials and my Likeness in any and all media now known or hereafter devised worldwide, in perpetuity. Without limiting the foregoing in any way, I further agree that the Producer may use my Likeness and the Materials in connection with any promotion, publicity, marketing or advertisement for the Program or any exploitation of the Program of any kind. I grant the rights hereunder whether or not I am selected to participate in the Program in any manner whatsoever. I release the Producer, the Network and/or any of their respective licensees, assigns, parents, partners, subsidiaries or affiliated entities and each of the employees, agents, officers and directors of the foregoing entities (collectively “Releasees”) from any and all liability arising out of the use of my Likeness and/or the Materials or in connection with any part of my application process for the Program including, without limitation, any termination by me of any modeling, management or other representation agreements. I agree not to make any claim against Releasees as a result of the recording or use of my Likeness and/or the Materials (including, without limitation, any claim that such use invades any right of privacy and/or publicity and any claims based on defamation or libel or false light). Without limiting the foregoing in any way, to the degree that the Materials include any musical or literary compositions in which I (partially or wholly) own, or to which I purport to (partially or wholly) own, the copyright or any publishing rights, I hereby grant to the Producer, and have the complete, unfettered right to grant to the Producer, an irrevocable, unlimited, perpetual, worldwide, royalty and payment-free license to use and reproduce such Materials in the Program and in connection with any promotion, publicity, marketing or advertisement for the Program or any exploitation of the Program of any kind, in any and all media now known or which may exist in the future. I understand that the Producer makes no representation that such Materials will or will not be used in any way. Any of the rights granted herein may be exercised by the Producer and their respective authorized agents, licensees, contractors, partners, successors and assigns. I understand and agree that the Network is a third party beneficiary to this agreement, and I acknowledge and agree that my performance of any obligations under this agreement is intended to benefit the Network.
I agree to keep in strictest confidence and to not use or disclose to any person, firm, website, or entity any information or trade secrets obtained or learned as a result of my participation in either the casting or production of the Program, including, without limitation, any information concerning or relating to the Program, the events contained in the Program, Producer’s production activities relating to the Program or the outcome of the Program that I read, hear or otherwise acquire or learn in connection with or as a result of my participation in either the casting or production of the Program (collectively, the “Confidential Information and Materials”) regardless of whether I am selected to participate in the Program or whether an episode of the Program has been exhibited which may include some or all of the Confidential Information and Materials, without the express prior written consent of a duly authorized representative of Producer.
CHOICE OF LAW
This agreement shall be deemed to be entered into in Los Angeles County, California, and shall be governed by and interpreted in accordance with the laws of the State of California applicable to agreements executed and performed entirely within the State of California. Subject to the arbitration provision below, any action, proceeding or litigation concerning this agreement or my appearance or participation in the Program may only be brought in Los Angeles County, California, and I hereby agree that the courts of Los Angeles County, California, shall have exclusive jurisdiction over me and the subject matter of any such proceeding.
This agreement expresses the entire understanding between me and the Producer and replaces any and all former and contemporaneous agreements, understandings or representations between me and the Producer. No modification, alteration or amendment of this agreement will be valid or binding unless in writing and signed by both me and the Producer.
RESOLUTION OF DISPUTES/BINDING ARBITRATION
THE PARTIES HERETO AGREE THAT ANY AND ALL DISPUTES OR CONTROVERSIES (REGARDLESS, BY WAY OF EXAMPLE ONLY, WHETHER SUCH DISPUTES OR CONTROVERSIES ARE BETWEEN PRODUCER AND/OR THE NETWORK, OR ANY OTHER TELEVISION NETWORK, ON THE ONE HAND, AND ME, ON THE OTHER HAND; BETWEEN ANOTHER PARTICIPANT AND ME; OR BETWEEN ME AND THE PROGRAM HOST) ARISING UNDER THIS AGREEMENT OR ANY OF ITS TERMS, ANY EFFORT BY ANY PARTY TO ENFORCE, INTERPRET, CONSTRUE, RESCIND, TERMINATE OR ANNUL THIS AGREEMENT, OR ANY PROVISION THEREOF, AND ANY AND ALL DISPUTES OR CONTROVERSIES RELATING TO MY APPEARANCE OR PARTICIPATION IN THE PROGRAM, SHALL BE RESOLVED BY BINDING ARBITRATION IN ACCORDANCE WITH THE FOLLOWING PROCEDURE: EITHER (I) PRODUCER AND/OR NETWORK, ON THE ONE HAND, AND I, ON THE OTHER HAND, SHALL MUTUALLY SELECT AN ARBITRATOR, WHO SHALL BE A RETIRED JUDGE OF A STATE OR FEDERAL COURT OR (II) IF WE CANNOT AGREE ON SUCH ARBITRATOR, PRODUCER AND/OR NETWORK ON THE ONE HAND, AND I, ON THE OTHER HAND, SHALL EACH SELECT ONE ARBITRATOR, WHO SHALL BOTH BE RETIRED JUDGES OF STATE OR FEDERAL COURTS AND THOSE TWO ARBITRATORS SHALL THEN SELECT A THIRD ARBITRATOR, WHO SHALL BE A RETIRED JUDGE OF A STATE OR FEDERAL COURT. ALL ARBITRATION PROCEEDINGS SHALL BE CONDUCTED UNDER THE AUSPICES OF THE AMERICAN ARBITRATION ASSOCIATION, UNDER ITS COMMERCIAL ARBITRATION RULES, THROUGH ITS LOS ANGELES, CALIFORNIA OFFICE. THE PARTIES HERETO AGREE THAT THE ARBITRATOR’S RULING, OR ARBITRATORS’ RULING, AS APPLICABLE, IN THE ARBITRATION SHALL BE FINAL AND BINDING AND NOT SUBJECT TO APPEAL OR CHALLENGE. THE PARTIES HERETO FURTHER AGREE THAT THE ARBITRATION PROCEEDINGS, TESTIMONY, DISCOVERY AND DOCUMENTS FILED IN THE COURSE OF SUCH PROCEEDINGS, INCLUDING THE FACT THAT THE ARBITRATION IS BEING CONDUCTED, WILL BE TREATED AS CONFIDENTIAL AND WILL NOT BE DISCLOSED TO ANY THIRD PARTY TO SUCH PROCEEDINGS, EXCEPT THE ARBITRATOR(S) AND THEIR STAFF, THE PARTIES’ ATTORNEYS AND THEIR STAFF, AND ANY EXPERTS RETAINED BY THE PARTIES. Notwithstanding the foregoing, nothing in this paragraph or in any of the applicable rules of the aMERICAN aRBITRATION aSSOCIATION shall prevent producer or the network from seeking provisional relief outside of arbitration, including but not limited to equitable and/or injunctive relief, pending the arbitrator’s final decision.
Without limiting the foregoing, any provision of this agreement that is invalid, illegal, or unenforceable in any jurisdiction will, as to that jurisdiction, be ineffective only to the extent of such invalidity, illegality or unenforceability, without affecting in any way the remaining provisions hereof in such jurisdiction or rendering that or any other provision of this agreement invalid, illegal or unenforceable in any other jurisdiction. Any laws that require or suggest that the interpretation of a document or agreement, or the resolution of any ambiguities contained therein, should be resolved against the drafter of the document or agreement, are hereby waived. No waiver by the Producer of any term or condition of this agreement will be construed as a waiver by the Producer of any other term or condition; nor will any waiver by the Producer of any default under this agreement be construed as a waiver by the Producer of any other default. It is further understood and agreed that no failure or delay in exercising any right, power or privilege hereunder shall operate as a waiver thereof, nor shall any single or partial exercise thereof preclude any other or further exercise thereof or the exercise of any right, power or privilege hereunder. The Producer and/or the Network may freely assign, in whole or in part, any of their respective rights or obligations under this agreement. I may not assign my rights and obligations under this agreement.