Apprentice Contestant India Application

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    CONTESTANT

    APPLICATION

    THE APPRENTICE ASIA

    1. Please fill out the application legibly.2. Use dark colored ink.

    3. Answer all questions honestly and to the best of your ability.

    4. Please write only on the printed side of the paper, but feel free to attach additional sheets if necessary.

    Name: Name you go by/Nickname:

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

    why:

    Address:

    Phone #: Home: Cell:

    Work: Other:

    Fax:

    E-mail address:

    Birth date (mm/dd/yy): Identity Card#:

    Age: Gender: M F

    I AM A LEGAL CITIZEN OF: I grew up in:

    Do you currently have a VALID PASSPORT?

    Passport Number: Expiration Date:

    Occupation:

    Highest Level of Education:

    School(s) Attended:

    Degree(s) Completed:

    Emergency Contact(s):

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    ARE OR HAVE YOU EVER BEEN A MEMBER OF ANY ASSOCIATION OF PROFESSIONAL ACTORS?

    HAVE YOU EVER ACTED, PERFORMED OR APPEARED ON TELEVISON OR FILM? IF SO, DESCRIBE:WHAT OTHER REALITY/GAME TV SHOWS HAVE YOU APPLIED TO OR BEEN ON? PLEASE LIST SHOWS,

    DATES OF APPLICATION & AIRDATES:

    ARE YOU CURRENTLY BEING CONSIDERED FOR ANY OTHER REALITY SHOWS, INCLUDING ANY GAME ORCONTEST SHOWS? IF SO, DESCRIBE:

    PART I: YOUR PROFILE

    HOW WOULD SOMEONE WHO REALLY KNOWS YOU DESCRIBE YOUR BEST QUALITIES?

    HOW WOULD SOMEONE WHO REALLY KNOWS YOU DESCRIBE YOUR WORST QUALITIES?

    WHERE WERE YOU BORN AND WHERE DID YOU GROW UP? HOW DID IT INFLUENCE YOU?

    TELL US ABOUT YOUR FAMILY AND/OR PEOPLE IMPORTANT TO YOU:

    DO YOU HAVE ANY PETS? IF SO, PLEASE LIST THEIR NAME(S) AND BREED(S):

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    DESCRIBE YOUR MOST EMBARRASSING MOMENT OR EXPERIENCE:

    WHAT WAS THE LAST UNUSUAL, EXCITING OR SPONTANEOUS OUTING YOU INSTIGATED?

    HAVE YOU EVER CHEATED WHILE WITHIN A RELATIONSHIP?

    DESCRIBE SOMETHING YOU WOULD DO IF YOU KNEW YOU WOULDNT GET CAUGHT:

    WHAT ARE YOU LIKE IN A ROOM FULL OF STRANGERS?

    WHAT TYPES OF PEOPLE INTIMIDATE YOU?

    DO YOU ENJOY TRAVELING? NOT INCLUDING YOUR PLACE OF RESIDENCE, IN WHICH CITIES AND/ORCOUNTRIES HAVE YOU LIVED AND FOR HOW LONG? WHY DID YOU LIVE IN EACH CITY OR COUNTRY?

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    DO YOU HAVE ANY SPECIAL TALENTS?

    WHAT IS YOUR FAVORITE BOOK?

    WHAT IS YOUR FAVORITE MOVIE?

    WHAT IS YOUR FAVORITE MUSIC ACT?

    WHAT IS YOUR FAVORITE SPORT?

    DESCRIBE ANY TATTOOS OR BODY ART YOU HAVE?

    PART II: YOUR MISSION STATEMENT

    HOW IMPORTANT IS MONEY TO YOU?

    HOW COMPETITIVE ARE YOU? HOW DO YOU REACT WHEN YOU LOSE?

    HOW WELL DO YOU WORK IN GROUPS?

    WHAT ABOUT WORKING WITHIN A TONY FERNANDES ORGANIZATION APPEALS TO YOU?

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    WHAT DO YOU THINK MR. FERNANDES CAN LEARN FROM YOU?

    WHAT ASSETS WOULD YOU BRING TO THE APPRENTICE ASIA? WHY DO YOU THINK YOU WOULD WIN?

    PART III: YOUR JOB HISTORY

    DESCRIBE YOUR JOB HISTORY. WHAT DO YOU CURRENTLY DO AND WHY ARE YOU GOOD AT IT?

    WHAT IS YOUR CURRENT ANNUAL SALARY?

    HOW LONG HAVE YOU WORKED AT YOUR CURRENT JOB?

    WHAT IS THE MOST IMPRESSIVE THING YOUVE EVER DONE AT WORK?

    WHAT ARE/WERE YOUR PARENTS OCCUPATIONS AND HOW HAVE THEY INFLUENCED YOUR LIFE?

    HAVE YOU EVER STARTED OR RUN YOUR OWN BUSINESS? WHAT WAS THE RESULT AND WHY? IF YES,PLEASE LIST THE NAME(S), LOCATION(S), AND TYPE(S) OF BUSINESS AND DATES OF OWNERSHIP:

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    HOW DO YOU HANDLE CONFLICT AT WORK?

    HAVE YOU EVER BEEN FIRED FROM A JOB(S)? IF YES, PLEASE LIST ALL AND THE REASON(S) FOR AND

    DATE(S) OF DISMISSAL:

    HAVE YOU EVER HAD TO FIRE AN EMPLOYEE FROM A JOB(S)? IF YES, DESCRIBE YOUR INVOLVEMENT INTHE PROCESS AND HOW YOU APPROACHED AND HANDLED THE SITUATION:

    HAVE YOU EVER RECEIVED ANY PROFESSIONAL OR EDUCATIONAL AWARDS? PLEASE DESCRIBE:

    DO YOU BELONG TO ANY CLUBS OR ORGANIZATIONS? DESCRIBE THEM:

    PLEASE LIST YOUR 3 BEST JOB REFERENCES. PLEASE INCLUDE CONTACT DETAILS AND A BRIEF

    EXPLANATION ABOUT THE REFERENCE:

    NAME CONTACT DETAILS EXPLANATION

    1.

    2.

    3.

    PLEASE LIST YOUR 3 WORST JOB REFERENCES. PLEASE INCLUDE CONTACT DETAILS AND A BRIEFEXPLANATION ABOUT THE REFERENCE:

    NAME CONTACT DETAILS EXPLANATION

    1.

    2.

    3.

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    PART IV: YOUR EDUCATION

    WHAT IS YOUR HIGHEST LEVEL OF EDUCATION? WHAT SCHOOLS DID YOU ATTEND (FROM HIGH SCHOOLAND UP, PLEASE LIST NAMES OF SCHOOLS, LOCATIONS, AND DEGREES EARNED):

    WHAT WAS THE BEST CLASS YOUVE EVER TAKEN? WHY?

    HAVE YOU EVER BEEN CAUGHT CHEATING IN SCHOOL? IF YES, PLEASE DESCRIBE THE CIRCUMSTANCES,INCLUDING WHERE AND WHEN IT OCCURRED

    HAVE YOU EVER BEEN EXPELLED FROM AN EDUCATIONAL PROGRAM OR SCHOOL? IF YES, PLEASEDESCRIBE THE CIRCUMSTANES, INCLUDING WHERE AND WHEN IT OCCURRED:

    PART VI: YOUR HISTORY

    HAVE YOU EVER HIT SOMEONE IN ANGER OR SELF DEFENSE? YES / NO (Circle One )

    IF SO, TELL US ABOUT IT, HOW OLD WERE YOU, WHAT HAPPENED?

    HAVE YOU EVER BEEN ARRESTED OR HAD A RESTRAINING ORDER PLACED AGAINST YOU?

    YES / NO (Circle One ) (If so, what was the charge and were you convicted?)

    DO YOU HAVE ANY CONDITIONS, SPECIAL NEEDS, OR FEARS THAT WE SHOULD KNOW ABOUT?

    YES / NO (Circle One ) IF SO, DESCRIBE:

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    HAVE YOU EVER BEEN CHARGED WITH A VIOLENT OFFENSE OR A FELONY? YES / NO (Circle One )IF SO, PROVIDE DETAILS:

    HAVE YOU EVER BEEN CONVICTED OF A VIOLENT OFFENSE OR A FELONY? YES / NO (Circle One )

    IF SO, PROVIDE DETAILS:

    HAVE YOU NOW OR HAVE YOU EVER OWNED OR APPEARED ON ANY WEB SITES? YES / NO (Circle One )

    IF SO, EXPLAIN:

    DO YOU KNOW ANYONE ELSE WHO IS APPLYING TO BE ON THE SHOW? YES / NO (Circle One )

    IF SO, GIVE NAME(S) AND DESCRIBE YOUR RELATIONSHIP WITH SUCH PERSON(S):

    DO YOU KNOW ANYONE INVOLVED IN THE PROD UCTION OF THE SHOW? YES / NO (Circle One )

    IF SO, GIVE NAME(S) AND DESCRIBE YOUR RELATIONSHIP WITH SUCH PERSON(S):

    HAVE YOU EVER BEEN PARTY TO A LAWSUIT? YES / NO (Circle One )

    IF SO, PROVIDE DETAILS:

    IF CHOSEN TO BE ON THE PROGRAM, IS THERE ANY PERSON OR PART OF YOUR LIFE THAT YOU

    WOULD PREFER NOT TO SHARE ON CAMERA? (I.E.,SOCIAL ORGANIZATIONS, ACTIVITIES,

    PERSONAL HISTORY, FRIENDS, FAMILY, ETC.) YES / NO (Circle One )

    EXPLAIN BELOW:

    WHO IS THE ONE PERSON WE COULD CALL AS YOUR CHARACTER WITNESS OUTSIDE OF YOUR FAMILY?

    NAME & PHONE #(S):

    LIST YOUR 3 CLOSEST FRIENDS THAT WE COULD CALL AS CHARACTER REFERENCES, NAME &

    PHONE #(S):

    WHAT IS THE CLOSEST AIRPORT TO YOUR HOME?

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    IF CHOSEN, ARE YOU PREPARED TO COMMIT A MAXIMUM OF (I) FOUR (4) DAYS FOR THE CASTINGSELECTION PROCESS IN JANUARY 2013, (II) SIX (6) WEEKS FOR FILMING OF THE SHOW DURINGFEBRUARY AND MARCH 2013 AND (III) FOUR (4) DAYS FOR PUBLICITY AND PROMOTIONAL ACTIVITIES INAPRIL AND/OR MAY 2013?

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    PART VII: RULES AND REQUIREMENTS

    The following eligibility requirements must be met in order to proceed with the application process:

    I. You must be legally eligible to work an d l ive in Asia. Proof of such eligibility must be provided to FremantleMedia

    Asia Pte. Ltd. and SPE NetworksAsia Pte. Ltd. (together, the Producers). Acceptable forms of proof include

    (without limitation) a valid passport or combination of a valid drivers license and valid identity card.

    II. You must be at least 21 years of age.

    III. You must be in excellent physical and mental health.

    IV. You must not now be a candidate for public office and must agree not to become one until six (6) months after

    initial broadcast of all programs in which you appear, if selected as a contestant.

    V. Any offer to become a contestant is conditioned upon your submission to physical and psychological examinations to

    be conducted in a country in Asia (which is yet to be determined) (the Casting Location) by medical

    professionals selected by and paid for by the Producers and the certification of the medical professionals that you

    meet all physical and psychological requirements. You will also need to return a Confidentiality and Non-Disclosure

    Agreement signed by you and your family members and the Official Rules.

    VI. You must be willing to travel to the Casting Location for up to four (4) days (or as otherwise scheduled by the

    Producers) for the final selection process. Pre-approved economy travel (roundtrip to and from the Casting Location

    and your home) and lodging to be provided by the Producers.

    VII. If you are selected as a contestant, you must be willing to travel to and reside at one or more undisclosed locations in

    Asia for up to six (6) weeks during production of the show and for up to an additional four (4) days after production of the

    show for publicity and promotional activities (or as otherwise scheduled by the Producers). Economy travel to be paid

    for by the Producers.

    VIII. Neither you nor any of your immediate family members or anyone living in your household may be or have been

    within the past two (2) years employees, officers, directors or agents of any of the following: (a) Mark Burnett

    Productions, Inc., FremantleMedia Asia Pte. Ltd., any Fernandes company, SPE NetworksAsia Pte. Ltd. or any

    television station owned and operated by AXN Holdings, LLC (AXN); (b) any person or entity involved in the

    development, production, distribution or other exploitation of the reality-based program currently entitled TheApprentice Asia(the Program) or any variation thereof; (c) any sponsor of the Program or its advertising agency;

    or (d) any person or entity supplying services or prizes to the Program. In addition, the Producers reserve the right to

    render ineligible any person who the Producers determine, in their 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.

    IX. You must not have appeared as a contestant in more than two (2) television competition reality-based shows within the

    last five (5) years from the tape date of the episode(s) of the Program in which you may appear. In addition, you may

    not have appeared as a contestant on more than one (1) television competition reality based show within the past

    twelve (12) months from the tape date of the episode(s) of the Program in which you may appear (regardless of

    whether such appearance has been broadcast or cablecast).

    The Producers reserve the right to amend the rules and requirements stated above at any time for any reason in the Producerssole discretion.

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    Please read, sign and date the following statement:

    I hereby acknowledge, represent, warrant and agree that (i) I have read, and I meet and agree to be bound by, the eligibility

    requirements; (ii) I have answered the previous questions honestly and accurately; (iii) Producers may contact any individual

    or organization which I have listed as a reference for information about me; (iv) if any of the above information is found to

    be false, I understand this will be grounds for my dismissal from The Apprentice Asiacontestant selection process and/or

    from theProgram, if selected; (v) even if I meet the eligibility requirements, the Producers have no obligation to interview

    me and/or select me as a contestant; (vi) even if I am selected as a contestant, the Producers have no obligation to produce

    the Program and AXN has no obligation to broadcast it, even if produced, (vii) all decisions by the Producers concerning theselection of the contestants are final and not subject to challenge or appeal; (viii) I agree to keep strictly confidential all

    information about the Program that I acquire during the contestant selection process and/or my participation in the Program; (ix) I

    am not under the influence of any medication, drugs or other substance that might impair my physical or mental ability to engage

    in the contestant selection process or the Program or that might impair my judgment while engaging in the contestant selection

    process and/or the Program; (x) I will follow all rules made by and directions given by the Producers in connection with the

    contestant selection process and the Program; and (xi) I understand that I will not be paid any money or given any other

    consideration for giving the Producers the rights listed herein or for signing this agreement.

    I hereby agree that I shall cooperate with the Producers to promote and give credit to any sponsors of the Program, the Producers

    and/or the AXN Network, both during and following completion of production, as requested by the Producers and I understand that

    this may include attending promotional events hosted by SPE Networks-Asia Pte. Ltd. and/or sponsor(s) of the Program. Further, I

    agree that I shall assist the Producers with the integration of sponsors products into the Program. Such promotional services may

    include, but are not limited to, using a sponsors product and/or wearing articles of clothing or accessories containing the Producersand/or a sponsors name and/or logo and conducting scripted interviews with sponsors and/or sponsor designees.

    I hereby authorize the Producers and AXN to investigate, access, collect and retain information about me, about any of the

    statements made by me in my application, any supporting documents and any other document that I have signed or do sign in

    connection with my application to be selected as a participant in the Program, or any other written or oral statements I make in

    connection therewith. I irrevocably authorize the Producers and AXN to secure information about my experiences from my

    current and former employers, associates, friends, family members, educational institutions, government agencies, credit reporting

    agencies and any references that I have provided, and I irrevocably authorize such parties to provide information concerning me. I

    hereby unconditionally and irrevocably release and forever discharge all such parties and persons from any and all liabilities

    arising out of or in connection with any such investigation. I specifically authorize investigation of my employment record and

    government records including, but not limited to, my motor vehicle records, criminal record, military record, credit and/or

    consumer report(s). I acknowledge and agree that any such information obtained by the Producers and AXN pursuant to this

    paragraph or otherwise may be used for purposes of selecting participants in the Program, and may be described or otherwiserelated in and in connection with the Program.

    I hereby authorize the Producers and AXN and any person or entity designated by such entities to conduct psychological and

    physical examinations of me as required by the Producers. I further authorize the individuals conducting such examinations of me

    to disclose to the Producers and AXN and their respective representatives all information about me obtained in connection with

    such examinations, and authorize the Producers and AXN to utilize such information in selecting participants for the Program.

    I hereby authorize the Producers and AXN and any person or entity designated by such entities to transfer any information

    collected in connection with my application to regions outside of Singapore, including, but not limited to, Malaysia and the United

    States.

    Without limiting my other confidentiality obligations, until the conclusion of the initial broadcast of the season of the Program in

    which I appear, I agree that I may not post a personal website (regardless of whether or not that site contains content relating to the

    Program) or post any messages or other online content on any web message board in connection with the Program, including, without

    limitation, the AXN website, unless otherwise approved by the Producers.

    MY PARTICIPATION IN THE CONTESTANT SELECTION PROCESS AND THE PROGRAM IS AT MY OWN RISK. I

    RELEASE THE PRODUCERS, AXN, THEIR JOINT VENTURES AND EACH OF THEIR RESPECTIVE PARENTS,

    SUBSIDIARIES, LICENSEES, SUCCESSORS AND RELATED AND AFFILIATED COMPANIES, AND EACH OF THEIR

    RESPECTIVE OFFICERS, DIRECTORS, AGENTS, EMPLOYEES, REPRESENTATIVES AND ASSIGNS, AND ALL

    OTHERS CONNECTED WITH THE PROGRAM, FROM ANY AND ALL CLAIMS, ACTIONS, DAMAGES, LIABILITIES,

    LOSSES, COSTS AND EXPENSES (INCLUDING, WITHOUT LIMITATION, REASONABLE COUNSEL FEES), IN ANY

    WAY ARISING OUT OF OR RESULTING FROM MY PARTICIPATING IN THE CONTESTANT SELECTION PROCESS

    OR THE PROGRAM INCLUDING, WITHOUT LIMITATION, ANY AND ALL CLAIMS, ACTIONS AND LIABILITIES

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    FOR INJURY, LOSS OR DAMAGE TO ME, TO ANYONE ELSE OR TO ANY PROPERTY, REGARDLESS OF WHETHER

    OR NOT SUCH INJURY, LOSS OR DAMAGE WAS CAUSED BY THE NEGLIGENCE OR WILLFUL MISCONDUCT OF

    THE PRODUCERS OR ANY OF THEIR RESPECTIVE OFFICERS, DIRECTORS, AGENTS, REPRESENTATIVES OR

    EMPLOYEES, OR ANYONE ELSE CONNECTED WITH THE PROGRAM. I AGREE TO DEFEND AND INDEMNIFY THE

    PRODUCERS, AXN, THEIR JOINT VENTURES AND EACH OF THEIR RESPECTIVE PARENTS, SUBSIDIARIES,

    LICENSEES, SUCCESSORS AND RELATED AND AFFILIATED COMPANIES, AND EACH OF THEIR RESPECTIVE

    OFFICERS, DIRECTORS, AGENTS, EMPLOYEES, REPRESENTATIVES AND ASSIGNS, AND ALL OTHERS

    CONNECTED WITH THE PROGRAM, AND HOLD THEM HARMLESS FROM ANY AND ALL LIABILITIES, CLAIMS,

    ACTIONS, DAMAGES, LOSSES, COSTS AND EXPENSES (INCLUDING, WITHOUT LIMITATION, REASONABLECOUNSEL FEES) OF ANY KIND OR NATURE WHATSOEVER IN ANY WAY CAUSED BY OR ARISING OUT OF MY

    PARTICIPATION IN THE CONTESTANT SELECTION PROCESS AND/OR THE PROGRAM.

    I understand and agree that, unless disclosed in advance to the Producers, I must not:

    (a) give or agree to give any member of the production staff and anyone associated in any manner with the Program, or

    any representative of the Producers anything of value to arrange my appearance on the Program; and

    (b) accept or agree to accept anything of value to promote any product, service or venture on the Program, or use any

    prepared material containing such a promotion where I know the writer/producer received personal consideration for it.

    Signature: Date:

    Please sign and date the following name and likeness release:

    By submitting this application I hereby consent to the recording, use and reuse by the Producers, AXN, their joint ventures

    and any of their respective licensees, assigns, parents, subsidiaries, successors, divisions, business units or related or affiliated

    entities and each of their respective employees, agents, officers, directors, representatives and assigns (collectively

    Releasees) of my voice, actions, likeness, name, appearance and biographical materials (collectively Likeness) in any

    and all media now known or hereafter devised, throughout the universe, 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 all right, title and interest in and to any materials that I provide

    to the Producers including, without limitation, the application video that I have provided in connection with the Program and

    any photographs (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, throughout the universe, in perpetuity. I

    further agree that Releasees may use my Likeness and the Materials in connection with any promotion, publicity, marketing

    or advertisement for the Program or for any of the Releasees in any manner whatsoever. I grant the rights hereunder whetheror not I am selected to participate in the Program. I release Releasees from any and all claims, actions, damages, liabilities,

    losses, costs and expenses arising out of or result ing from their exercise of their rights under this agreement. 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 to privacy and/or publicity).

    This agreement shall be governed by and construed in accordance with the laws of the Republic of Singapore, without regard to

    choice of law principles. All actions and proceedings arising in connection with, touching upon or relating to this agreement, the

    breach thereof and/or the scope of this paragraph shall be submitted to the Singapore International Arbitration Centre (SIAC) for

    final and binding arbitration under its Rules of Arbitration to be held in Singapore, in the English language, before a single arbitrator

    who shall be a retired judge. The arbitration shall be selected by mutual agreement of the parties or, if the parties cannot agree, then

    by striking from a list of arbitrators supplied by SIAC. The arbitration shall be a confidential proceeding, closed to the general

    public. The arbitrator shall assess the cost of arbitration against the losing party. In addition, the prevailing party in any arbitration

    or legal proceeding relating to this agreement shall be entitled to all reasonable expenses (including, without limitation, reasonable

    attorneys fees). Notwithstanding the foregoing, the arbitrator may require that such fees be borne in such other manner as the

    arbitrator determines is required in order for this arbitration clause to be enforceable under applicable law. The arbitrator shall issue

    a written opinion stating the essential findings and conclusions upon which the arbitrators award is based. The arbitratorshall have

    the power to enter temporary restraining orders and preliminary and permanent injunctions. Neither party shall be entitled or

    permitted to commence or maintain any action in a court of law with respect to any matter in dispute until such matter shall have

    been submitted to arbitration as herein provided and then only for the enforcement of the arbitrators award; provided, however, that

    prior to the appointment of the arbitrator or for remedies beyond the jurisdiction of an arbitrator, at any time, either party may seek

    equitable relief in a court of competent jurisdiction in Singapore or, if sought by the Producers, such other court that may have

    jurisdiction over me without thereby waiving their right to arbitration of the dispute or controversy under this section.

    Notwithstanding anything to the contrary herein, I hereby irrevocably waive any right or remedy to seek and/or obtain injunctive or

    other equitable relief or any order with respect to, and/or to enjoin or restrain or otherwise impair in any manner, the production,

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    distribution, exhibition or other exploitation of any motion picture, production or project related to the Producers, AXN, their

    parents, subsidiaries and affiliates, or the use, publication or dissemination of any advertising in connection with such motion

    picture, production or project.

    I acknowledge that no other party nor any agent or attorney of any other party has made any promise, representation or warranty

    whatsoever, express or implied, not contained herein concerning the subject matter hereof, to induce me to execute this document

    and I acknowledge that I have not executed this instrument in reliance on any such promise, representation or warranty not

    contained herein. Any waiver by the Producers of any term of this agreement in a particular instance shall not be a waiver of such

    term for the future. I agree that the invalidity or enforceability of any part of this agreement shall in no way affect the validity orenforceability of any of the remainder of this agreement.

    I have signed this release on the day of , 2012.

    Signature:

    Name (printed or typed):

    Please send your completed application form and video to:

    The Apprentice Asia

    FremantleMedia Asia Pte Ltd

    10 Raeburn Park, Block A #03-02/03

    Singapore 088702