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BIG BROTHER USA

VIEWS: 5 PAGES: 14

  • pg 1
									                                        BIG BROTHER 9
                                         APPLICATION

At this point there is no absolute application deadline. However, Producers reserve the right to
stop accepting applications without notice so Producers highly encourage applicants to submit
applications as soon as possible. Semi-finalist interviews will be determined by Producers at
their sole discretion.

Please read the Eligibility Requirements/Application Instructions before completing this
application. And remember, above all else, you must BE HONEST! Any answer may be
verified for accuracy. Don't answer a question hoping to give us the answer we "want" to hear.

Region Number of the city located closest to your home: ____________
(Refer to the Eligibility Rules/Application Instructions for this information)

Section I: The Basics

1
First Name  _____________________________
Middle Name _____________________________
Last Name   _____________________________

2
Have you ever formally or otherwise changed your name? If so, what other names have you used
and why?
______________________________________________________________________________
______________________________________________________________________________

3
Height         _____________________________
Weight         _____________________________
Dress Shirt Size (S, M, L, XL)_________________
T-Shirt Size (S, M, L, XL) ____________________
Swimsuit Size _____________________________
Jacket Size________________________________
Chest Size     _____________________________
Waist Size     _____________________________
Pant Size__________________________________
In Seam (men only)__________________________
Dress Size (women only) _____________________
Bra Size (women only) _______________________
Underwear Size _____________________________
Shoe Size      ______________________________
Hat Size ___________________________________
Left handed_______           Right handed________
Eye color_________

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4
Social Security Number _____________________________
Driver’s License Number _____________________________

5
Home Street Address (No P.O. Box numbers!)  _____________________________
City ________________________________ State ___________________ Zip Code ________

6
Contact Numbers
Phone (Work) _____________________________
Phone (Home) _____________________________
Mobile (if any)_____________________________
Pager (if any) _____________________________

7
Email Address (If you don't have one, tell us why you don’t.)
______________________________________________________________________________

8
Name, Phone Number, and Address of your Best Friend.
______________________________________________________________________________

9a
Name, Phone Number, and Address of the Relative that lives closest to you.
______________________________________________________________________________

9b
Name, Phone Number, and Address of an Emergency Contact for you (if different from 9a).
______________________________________________________________________________

10
Do you have a homepage on the Internet? If so, what is the address?
______________________________________________________________________________

11
Gender (Circle one)      MALE         FEMALE

12
Age (As of today) _________________________
Date of Birth (Month/Day/Year) ______________

13
Relationship/Marital Status (Circle one and answer questions as applicable)


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SINGLE

BOYFRIEND or GIRLFRIEND               How long? _______________________________

MARRIED                               How long? _______________________________
                                      Any previous marriages? If so, how many? _____

NOT MARRIED, BUT LIVE W/SIGNIFICANT OTHER                      How long? ___________

SEPARATED                             How long? _______________________________

DIVORCED                              How long have you been divorced? ____________
                                      How long were you married? _________________
                                      Any previous marriages? If so, how many? ______

WIDOWED                               How long have you been widowed? ____________
                                      How long were you married? _________________
                                      Any previous marriages? If so, how many? ______

14a
If you are married or in a relationship, how would you rate your relationship on a scale of 1-10 (1
being worst, 10 being best)? Please explain.
______________________________________________________________________________
______________________________________________________________________________

14b
If you are married or in a relationship, how will your partner feel about the potential 3-month
separation?
______________________________________________________________________________
______________________________________________________________________________

15a
What is the highest level of education you’ve completed? (Circle one and answer questions as
applicable)

NO SCHOOLING

HIGH SCHOOL

ASSOCIATE COLLEGE DEGREE

BACHELOR'S COLLEGE DEGREE
Degree(s)/Major(s)? ________________________________

MASTER’S COLLEGE DEGREE
Degree(s)/Subject(s)? _______________________________

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PROFESSIONAL OR DOCTORAL DEGREE
Degree(s)/Subject(s)? ______________________________

15b
What school(s)/colleges(s)/university(ies) have you attended/are you attending? (Include the city
and state.) If you’re currently a student, tell us about your major(s) or course of study.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

16
Are you now serving, or have you ever served, in the military (U.S. or otherwise)? If so, please
describe which branch of the military, your serial number, highest rank, and when and where
served. If you’ve left the service, when were you discharged and why? Was it an honorable or
dishonorable discharge?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

17
Are you a professional performer within the entertainment industry? If so, what do you do?
_____________________________________________________________________________
_____________________________________________________________________________

18a
Do you have any acting, singing or performing aspirations? If so, tell us your wishes and goals.
_____________________________________________________________________________
_____________________________________________________________________________

18b
Have you ever appeared in any television programs or films or movies or commercials or
advertisements of any kind? If so, please provide details and describe when you made such
appearance(s).
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

19
Have you ever been arrested, charged with a crime, and/or been subjected to disciplinary charges
of any kind (whether through a private or public entity)? If so, please describe the circumstances
of the arrest(s), and the charge(s) and/or accusations (include dates and locations). Were you
convicted or disciplined, and, if so, in what way?

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_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

20
Have you ever had a restraining order issued against you? If so, tell us about it (include dates,
city & state).
_____________________________________________________________________________
_____________________________________________________________________________


21
Have you ever had a restraining order issued against someone else? If so, tell us about it
(include dates, city & state).
_____________________________________________________________________________
_____________________________________________________________________________

22
Have you ever been involved in any litigation? Are you involved in any pending litigation? If
so, tell us about it (include dates).
_____________________________________________________________________________
_____________________________________________________________________________


Section II: Family & Lifestyle

23
Do you have any children? If so, please list their name(s) and age(s):
_____________________________________________________________________________
_____________________________________________________________________________

24
Regardless of your marital status, describe your ideal romantic partner:
_____________________________________________________________________________
_____________________________________________________________________________

25
Describe your relationship with your mother.
_____________________________________________________________________________
_____________________________________________________________________________

26
Describe your relationship with your father.
_____________________________________________________________________________
_____________________________________________________________________________

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27
What is your current occupation? Please provide a job description.
_____________________________________________________________________________
_____________________________________________________________________________

28
What is/are your favorite food(s)?
_____________________________________________________________________________
_____________________________________________________________________________


29
Do you smoke? If so, what do you smoke and how often?
_____________________________________________________________________________

30
Do you drink alcohol? If so, how often do you drink and how much?
_____________________________________________________________________________

31
If you drink, how often do you get drunk? How do you act when you get drunk?
_____________________________________________________________________________

32
What are your thoughts on religion?
_____________________________________________________________________________

33
Are politics important to you? How often do you vote?
_____________________________________________________________________________
_____________________________________________________________________________

34
Have you had any particularly interesting occupation(s) in your past? If so, tell us about it/them.
_____________________________________________________________________________
_____________________________________________________________________________

35
Do you have any pets? If so, please list their name(s) and type(s).
_____________________________________________________________________________
_____________________________________________________________________________

36
Are you a vegetarian? Do you have any food limitations (e.g. allergies, religious, etc.)?
_____________________________________________________________________________

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_____________________________________________________________________________

37
Have you ever lived with roommates? If so, tell us about it.
_____________________________________________________________________________
_____________________________________________________________________________

38a
What’s your favorite TV show?
_____________________________________________________________________________


38b
What’s your favorite movie?
_____________________________________________________________________________

33c
What kind of music do you like best?
_____________________________________________________________________________

39
What magazines do you read?
_____________________________________________________________________________

40
What is your favorite color? Why?
_____________________________________________________________________________

41
Do you belong to any affiliations or organizations?
_____________________________________________________________________________
42
Do you have any body art (piercings, tattoos, etc.)? If so, please describe them.
_____________________________________________________________________________

43
What are your favorite sports to play? To watch?
_____________________________________________________________________________
_____________________________________________________________________________

44 What are your favorite activities?
_____________________________________________________________________________
_____________________________________________________________________________




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Section III: Medical & Psychological

44a
Have you been treated for or suffered from any physical or mental illnesses (other than common
colds) within the last ten (10) years? (Circle one)

YES       NO

44b
If you answered "YES" in Question 44a, please provide details, including dates of such mental
and/or physical illness(es) (regardless of whether they were diagnosed or undiagnosed and
regardless of whether any medical attention was sought), any diagnoses, treatments, any
medications taken in connection with such illnesses and the purposes of such medications, and
symptoms experienced in connection with such illness(es).
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

45
Have you ever sought mental health counseling in any form? If so, please provide details.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

46
Please list any allergies you have (medications, food, hay fever, dust, etc.) and your current
treatment for them (if any).
_____________________________________________________________________________
_____________________________________________________________________________

47
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.
_____________________________________________________________________________
_____________________________________________________________________________

48
Do you have a temper? How often do you lose your temper? What provokes you?
_____________________________________________________________________________

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_____________________________________________________________________________

49
How do you deal with anger?
_____________________________________________________________________________
_____________________________________________________________________________

50
How do you deal with someone who intimidates you?
 _____________________________________________________________________________
_____________________________________________________________________________

51
When was the last time (if any) you hit, punched, kicked, or threw something in anger? Please
provide details.
_____________________________________________________________________________
_____________________________________________________________________________

52
What are you afraid of (e.g., heights, flying, etc.)?
_____________________________________________________________________________
_____________________________________________________________________________


Section IV: Your Chance to be Creative

53
List the three adjectives that best describe you.
_____________________________________________________________________________

54
If you could hold any political office, what would it be and why?
_____________________________________________________________________________
_____________________________________________________________________________

55a
What is the accomplishment you are most proud of?
_____________________________________________________________________________
_____________________________________________________________________________

55b
What are you most ashamed of, either now or in your past?
_____________________________________________________________________________

56
Describe your perfect day.

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_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

57
Who is your hero and why?
_____________________________________________________________________________
_____________________________________________________________________________

58
List three (3) items you would take with you into the Big Brother house if allowed and why.
_____________________________________________________________________________
_____________________________________________________________________________

59
Have you ever been to a nude beach? If so, what was it like?
_____________________________________________________________________________
_____________________________________________________________________________

60
Finish this sentence: “My life's motto is…”
_____________________________________________________________________________
_____________________________________________________________________________

61
What would you do if “Big Brother” made you famous?
_____________________________________________________________________________
_____________________________________________________________________________

62
What types of people would you choose to have living with you in the “Big Brother” house?
_____________________________________________________________________________
_____________________________________________________________________________

63
What types of people would you NOT choose to live with you in the house?
_____________________________________________________________________________
_____________________________________________________________________________

64
What would irritate you about living in a house with about a dozen other people?
_____________________________________________________________________________
_____________________________________________________________________________



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65
What do you think would be the most difficult part of living in the “Big Brother” house?
Explain.
_____________________________________________________________________________
_____________________________________________________________________________

66
Which past “Big Brother” houseguest did you like the most? The least? Explain.
_____________________________________________________________________________
_____________________________________________________________________________

67
Do you have a strategy for winning “Big Brother”?
_____________________________________________________________________________
_____________________________________________________________________________

68
Aside from the cash prize, what do you hope to gain from winning “Big Brother”?
_____________________________________________________________________________
_____________________________________________________________________________

69
A recurring theme on “Big Brother” is “expect the unexpected.” How would you handle “the
unexpected?” Are there any possible twists on the show that would be particularly challenging
for you to handle?
_____________________________________________________________________________
_____________________________________________________________________________

70
Is there anything else you'd like to tell us about yourself and why you think you'd make a great
Big Brother participant and housemate? Try to differentiate yourself and be creative!
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

71
Have you ever applied for and/or appeared on any other reality TV shows, dating shows or game
shows? If so, please provide details and dates.
_____________________________________________________________________________
_____________________________________________________________________________

Read and sign the Release and Waiver below and you’re done!



43520.9
                                            Page 11
                                    RELEASE AND WAIVER



Please Print Your Full Name: ____________________________


Please read, fill out, sign, and date the following:


I hereby acknowledge that: (i) I have read, and I meet and agree to be bound by, the Big Brother eligibility
requirements; (ii) I have answered the previous questions honestly and accurately and will answer any
questions put to me by Our House Productions, Inc. (“Producers”) honestly and accurately; (iii) If any
information that I provide to the producers of Big Brother is found to be false or incomplete this will be
grounds for dismissal from the Big Brother participant selection process, and/or removal from the Big
Brother program, if previously selected as a participant; (iv) Even if I meet the eligibility requirements, the
Producers have no obligation to interview me, and/or select me as a participant; (v) Even if I am selected as
a participant, Producers have no obligation to produce the program and CBS has no obligation to broadcast
it, even if conducted; (vi) In the event the show is cancelled, or not broadcast for any reason, Producers and
CBS have no obligation to award any prize money; (vii) All decisions by Producer concerning selection of
the participants are final and not subject to challenge or appeal; and (viii) Producers have no obligation to
return or maintain any materials submitted as part of the application whether or not the applicant is selected
as a cast member. 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 Releasees, and have the
complete, unfettered right to grant to the Releasees, 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 Releasees make no representation that such Materials will or will not be used in any way.

By submitting this application I hereby consent to the recording, use and reuse by the Producers of the
reality-based television series currently entitled “Big Brother” (the “Program”), CBS Broadcasting Inc.,
Endemol USA Inc., Endemol Entertainment USA, Inc., Our House Productions, Inc. and any of their
respective licensees, assigns, parents, subsidiaries or affiliated entities and each of the respective
employees, agents, officers and directors (collectively “Releasees”) of my voice, 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. I agree that Releasees
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 Releasees exclusively own the application materials (videos, photos, etc.)
that I have provided in connection with the Program and any photos and video that Producers will make of
me in connection with the program (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. I further agree that Releasees may use my likeness and the Video in
connection with any promotion, publicity, marketing or advertisement for the Program. I grant the rights
hereunder whether or not I am selected to participate in the Program in any manner whatsoever. I release
Releasees from any and all liability arising out of their use of my Likeness and/or the Materials. I agree
not to make any claim against Releasees as a result of the recording or use my Likeness and/or the

43520.9
                                                   Page 12
Materials (including, without limitation, any claim that such use invades any right of privacy and/or
publicity).

                                         ENTIRE AGREEMENT

This release and waiver expresses the entire understanding between me and the Releasees and replaces any
and all former and contemporaneous agreements, understandings or representations between me and the
Releasees. No modification, alteration or amendment of this agreement will be valid or binding unless in
writing and signed by both parties.

                                            CHOICE OF LAW

This release and waiver 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 fully carried out within California. Subject to the arbitration provisions in the next
immediate paragraph below, any action, proceeding or litigation concerning this release or my appearance
or participation in the Program may only be brought in Los Angeles County, California, and Producers 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.

                                    ARBITRATION OF DISPUTES

PRODUCERS AND I AGREE THAT ANY AND ALL DISPUTES OR CONTROVERSIES
ARISING UNDER OR RELATING TO 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 ARISING UNDER OR RELATING TO MY
POSSIBLE APPEARANCE OR PARTICIPATION IN THE PROGRAM, SHALL BE RESOLVED
BY BINDING ARBITRATION IN ACCORDANCE WITH THE FOLLOWING PROCEDURE:
EITHER (I) THE RELEASEES AND I 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, THE RELEASEES AND I 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 ALSO BE A RETIRED JUDGE OF A STATE OR FEDERAL
COURT. ALL ARBITRATION PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE
WITH THE COMMERCIAL ARBITRATION RULES OF THE AMERICAN ARBITRATION
ASSOCIATION, THROUGH ITS LOS ANGELES, CALIFORNIA OFFICE. PRODUCERS AND
I 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. PRODUCES AND I 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; PROVIDED THAT SUCH
ARBITRATOR(S) AND THEIR STAFF, THE PARTIES' ATTORNEYS AND THEIR STAFF,
AND ANY EXPERTS RETAINED BY THE PARTIES EACH FIRST AGREE IN WRITING
THAT SUCH INFORMATION AND DOCUMENTS WILL BE TREATED BY THEM AS
CONFIDENTIAL, CONSISTENT WITH THIS PROVISION. NOTWITHSTANDING THE

43520.9
                                                  Page 13
FOREGOING, NOTHING IN THIS PARAGRAPH OR IN ANY OF THE APPLICABLE RULES
OF THE AMERICAN ARBITRATION ASSOCIATION SHALL PREVENT THE RELEASEES
FROM SEEKING PROVISIONAL RELIEF OUTSIDE OF ARBITRATION, INCLUDING BUT
NOT LIMITED TO EQUITABLE AND/OR INJUNCTIVE RELIEF, PENDING THE
ARBITRATOR’S FINAL DECISION

                                            MISCELLANEOUS

Without limiting the foregoing, any provision of this release and waiver 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 any of the Releasees of any term or
condition of this agreement will be construed as a waiver by any of the Releasees of any other term or
condition; nor will any waiver by any of the Releasees of any default under this release and waiver be
construed as a waiver by the Releasees 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 Releasees may freely assign, in whole or in part, any of their
rights or obligations under this release and waiver. I may not assign my rights and obligations under this
agreement.

I have signed this release and waiver together with my application on the _________ day of __________,
200__.

Signature _________________________________

Print Name _______________________________




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