Please Attach a Clear Recent Photo: *
First Name *
Last Name *
Cell Phone: *
Date of Birth: *
Place of Employment: *
Please describe your job title and line of work *
Are you legally authorized to live and work in the United States? *
Do you have a personal website, or are you a part of any social networking sites (Myspace, Facebook, Twitter, etc)? Please list: *
Describe your personality: *
What are peoples first impressions of you? *
What is your lifestyle like? Do you have any hobbies or passions? *
Who do you live with? Please list all names, ages, relationship, and length of time you have been living with them. *
Describe your family/household dynamic: *
What big life events or decisions do you have coming up? *
What has been the most challenging obstacle you’ve had to face in your life? Have you overcome it? How did you overcome it? *
Are you currently under consideration for any other shows? If yes, please list: *
Have you been on TV before? If so, list the show(s), network(s) and date(s) they aired *
You must be at least 18 years of age. Or if you reside in one of the below states, you must be at least the following in age:
Alabama: 19 years or older
District of Columbia: 21 years or older
Mississippi: 21 years or older
Nebraska: 19 years or older
You must be either a United States citizen or a legal permanent resident, and be living in the United States.
You must not be a candidate for public office and must agree not to become one until after one (1) year after the initial exhibition of the episode(s) of the reality-based program currently entitled “UNTITLED CUL-DE-SAC PROJECT” (the “Program”) in which you appear, if selected as a participant.
You may not participate in the Program if your participation would create impropriety or the appearance of impropriety. In making this determination, producer of the Program (“Producer”) will consider, among other things, whether you, any member of your immediate family and/or anyone living in your household (whether related or not) 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, media company (including radio station), station or distributor, or digital streaming service or other digital platform, that exhibits or distributes the Program;
b) Producer, or any other person or entity involved in the development, production, distribution or other exploitation of the Program or any variation thereof;
c) Any sponsor of the Program or its advertising agency; or
d) Any person or entity supplying 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 or distribution of the Program, such that his or her participation in the Program could create the appearance of impropriety.
If selected as a participant you must execute waivers and release agreements required by Producer or any of its licensees, successors or assigns.
You may be required, and must be willing, to submit medical information to the production, and you may be required, and must be willing, to submit to a medical examination, psychological examination and background check. Any offer to become a participant may be conditioned upon your submission to such examinations and investigations to be conducted by professionals selected by and paid for by Producer, 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.
Being chosen to interview at any level will not ensure that you will be selected to continue through the selection process. Producer reserves the right to disqualify or exclude, in its sole discretion, any individual from the interview and selection process at any time. Producer also reserves the right to change the eligibility rules and selection procedures at any time.
RELEASE AND WAIVER *
ELECTRONIC SIGNATURES. This application may be executed by original, facsimile or electronic signature. Any signed copy of this application delivered by facsimile or electronic transmission shall for all purposes be treated as if it had been delivered containing my original signature, and shall be binding upon me in the same manner as though an original signed copy had been delivered.
By signing below, I understand that it constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. * *