Big Brother Mzansi Application Form – Fill Out and Use This PDF

Big Brother Mzansi – Information for Applicants

Please read, sign and date the following statement:

I hereby acknowledge and confirm that:

1.I am aware that Endemol ("the Producers") will consider the information supplied by me in this document for purposes of considering me as a participant in the Big Brother Mzansi production.

2.I have read and agree to be bound by the conditions set out in this document entitled Big Brother Mzansi – Audition form;

3.I have answered all of the questions on the audition form fully, honestly and accurately and I confirm I have not misled or attempted to mislead the Producers in any way as to my identity, experiences or in any other way;

4.If any of the information I have given in the audition form is found to be false, the Producers will be entitled to exclude me from the Big Brother Mzansi participant audition process.

5.If I am short listed by the Producers, I am prepared to undergo psychological and medical screening. I understand that the full details of this will be explained to me in advance.

6.If I am short-listed I also agree to authorise the Producers to conduct background checks in order to verify any of the information I have supplied. I understand that consenting to these checks is no guarantee of being chosen to participate.

7.Even if I am selected as a participant, the Producers have no obligation to produce the programme and even if the programme is made there will be no obligation on the Producers or any broadcaster to broadcast it;

8.All decisions by the Producers concerning selection of the participants are final and no reasons will be given. I agree not to challenge or appeal against those decisions.

9.I will keep strictly confidential and will not, without the prior written consent of the Producers, at any time from the date I sign this audition form and for twelve (12) months following the first transmission on television of the final episode of Big Brother Mzansi, disclose, publish or reveal to any person any incident, conversation or information concerning the series or the audition/selection process which comes to my knowledge as a result of my inclusion in the participant selection process and/or the Big Brother Mzansi series, if selected, nor other information relating to Endemol, M-Net/MultiChoice Group of Companies or the Big Brother Mzansi series acquired by me during this period, without consultation with the publicity organs of either Endemol, M-Net or MultiChoice Group of Companies.

10.If I am selected to participate in the Big Brother Mzansi production, I agree to enter into a formal agreement with the Producers and/or any other relevant party, the terms and conditions of which will be necessary to protect the rights of the Producers and/or such other entity involved in the production of Big Brother Mzansi.

11.I hereby assign to Endemol, M-Net or MultiChoice Group of Companies the right to use my photographs, likeness, profile, voice, sound effect, caricature, literary, artistic and musical materials and the like for purposes of the Programme and/or any related publicity and marketing, which Endemol, M-Net, MultiChoice Group of Companies accept.

12.I am not an employee of Endemol, M-Net, MultiChoice or any of the M.I.H. Group of companies.

13.I am not related to an Endemol, M-Net, MultiChoice or any other M.I.H. Group of companies’ employee.

14.I am a legal resident or a citizen of South Africa with a valid ID book or passport

15.I will be 21 years of age or more on the 1s of January 2014

Date: / /2013

Signature:

Name (please print):

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1. YOUR BIOGRAPHICAL INFORMATION

First name(s):

Surname:

What do your friends call you?

Maiden name:

Age:

Height:

Weight:

Date of Birth:

Place of Birth

Please indicate whether you are a:

SA citizen

Legal Resident

If you are a SA citizen

SA ID Number:

If you are a Legal Resident

Passport no:

Nationality

Type of Visa:

Visa expiry date

Or work permit no:

W/permit expiry date

Please indicate whether you are:

Male

Female

Weight

Height

Home language:

Other languages you speak:

Do you have any children

Yes

No

If so, please indicate their age and gender

2. WHO YOU ARE

Each of the following questions should be answered in 100 words or less, except where indicated. 2.1 Describe yourself.

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2.7 Media history

If the answer is yes, this does not necessarily mean you are excluded from consideration.

Please provide details of your previous television appearances, including the names of programmes, broadcast dates and broadcaster.

3. YOU AND OTHERS

Each of the following questions should be answered in 100 words or less.

3.1 Describe your family and how you get along.

3.2 Describe your friends and friendships.

3.3 Relationship Status

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3.4Tell us something about yourself that you don’t normally share with others

3.5 Do you have a hidden talent?

4. YOU AND BIG BROTHER

Each of the following questions should be answered in 100 words or less, except where indicated. 4.1 I want to be in the Big Brother Mzansi house because . . .

5. YOUR HEALTH AND LIFESTYLE

Do you participate in any unusual recreational activities?

Please indicate if you have any special dietary requirements (e.g. Vegan, kosher, halaal etc.)

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5.1 Your responses to the following questions will not exclude you from consideration.

Do you have chronic health problems (allergies, diabetes etc.)?

Yes

No

If the answer is yes, please provide details of the ailment(s).

5.2. Do you have a criminal record, or any legal action pending against you?

5.3Is there anything else we should know about you? Please volunteer any further information, both positive (you may have won some important awards) and negative that you believe we would want to know about and that is likely to emerge in the background check.

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