Applying for 'Take Me Out'

TAKE ME OUT GIRLS APPLICATION FORM 2011
FULL NAME: (as on passport)
Holly Stewart
FIRST NAME THAT YOU PREFER TO BE CALLED:	AGE:
Holly	18
HOME ADDRESS:
WINDRUSH, HIGHWORTH, SWINDON
YOUR CONTACT NUMBERS:
OFFICE: HOME: MOBILE
YOUR EMAIL ADDRESS:
mynameiscal@gmail.com
CITY OR TOWN ORIGINALLY FROM:
SWINDON
ARE YOU:   SINGLE / MARRIED / SEPARATED / DIVORCED
Single
HAVE YOU EVER BEEN MARRIED OR ENGAGED?  IF YES – HOW MANY TIMES?
Nope never
CURRENT OCCUPATION:
Student
PREVIOUS JOBS:
Emptying bins
WHO DO YOU LIVE WITH?
Mum, Dad, Brother and the cat.
HOW TALL ARE YOU? (in Feet and Inches)
5ft and a bit
ARE THERE ANY DATES BETWEEN NOW AND NOVEMBER 2011 THAT YOU WOULD NOT BE AVAILABLE FOR AUDITIONS OR RECORDINGS?
Nah
DO YOU HAVE ANY MEDICAL CONDITIONS OR DISABILITIES WHICH WE SHOULD BE AWARE OF AND/OR ANY SPECIAL REQUIREMENTS -  IF YOU ARE REQUIRED TO ATTEND AN AUDITION?
WE ARE HOPING TO HOLD AUDITIONS IN (OR NEAR) SOME OF THE FOLLOWING CITIES: ♥  MANCHESTER  ♥  LIVERPOOL ♥ BIRMINGHAM  ♥  NOTTINGHAM  ♥  CARDIFF  ♥  BRISTOL  ♥ ♥ LONDON  ♥ EXETER  ♥  BELFAST  ♥  LEEDS  ♥   NEWCASTLE  ♥  GLASGOW ♥ EDINBURGH ♥ IF  OFFERED  AN AUDITION – PLEASE INDICATE WHICH WOULD BE YOUR 1ST & 2ND MOST CONVENIENT CITIES:
1st. London 2nd Bristol
PLEASE NOTE – owing to the numbers of people who apply – not everyone who applies for this show can be offered an audition. Auditioning does not guarantee a place on the show.
HOBBIES & INTERESTS:  (please include sports that you take part in or watch, clubs you belong to, musical instruments you can play etc)
Eating, watching the news, eating, cats, playing the mandolin, monkeys, eating cats and getting the bus.
HAVE YOU EVER APPEARED ON A TV SHOW? (Please give dates & details)
I was in Blue Peter once, they were filming the ‘Bikeathon’ in my town (SWINDON REPRESENT) and I was stood behind Liz Barker. I was 9 though.
DO YOU HAVE ANY SPECIAL TALENTS?  (Funny or serious)
No I’m not special enough for talent.
DO YOU HAVE ANY UNUSUAL OR IRRITATING HABITS?
I find the sound of people being sick really funny. I also don’t like touching metal.
WHAT QUALITIES WOULD YOUR IDEAL MAN HAVE? (Looks, features, personality)
Nerdy and hilarious.
ARE ANY OF YOUR FAMILY MEMBERS SINGLE? SISTER / BROTHER / MUM / DAD / DAUGHTER / SON (Give details below of anyone aged 18+):
My older brother will always be single.
HOW DID YOU FIRST HEAR ABOUT APPLYING FOR THIS SHOW? (Please be specific, eg if it was a website please say which one or if it was an email please say who from)
I was suggesting my friend to apply but I decided I might instead.
PLEASE GIVE US THE CONTACT PHONE NUMBERS OF TWO GOOD FRIENDS OR RELATIVES THAT WE COULD CONTACT IN CASE OF EMERGENCIES: (please state relationship)
1.Bev (mum) I’m not giving you her number you perve 2.Pete (Dad) – Same again.
PLEASE  POST  FORM WITH PHOTO TO: TAKE ME OUT TALKBACKTHAMES TELEVISION 1 STEPHEN STREET, LONDON W1T 1AL OR EMAIL  WITH PHOTO TO:  takemeoutgirls@talkbackthames.tv APPLICATIONS WITHOUT PHOTOS WILL NOT BE CONSIDERED!
Will you allow us to hold this info on our talkbackThames TV contestant database?	YES
May we pass this information on to our other quiz show programmes?	YES
I confirm that I have read, understood and agree to the “Take Me Out” Application Terms & Conditions.  I confirm that all information provided herein is accurate, truthful and is in no way misleading and I consent to this information being used in the show should I be selected. SIGNED:  ............<<~~~~~~~~holly stewart~~~~~>>.   DATE:  ..15th SEPTEMBER 2010...... Print Name: ....................H O L L Y S T E W A R T...................................................... PRIVACY: We take your privacy very seriously. By submitting this application form, you consent to any personal information that you provide being used for the purpose of assessing your suitability for the Programme, and if successful, for the production of the Programme (in whatever format). If you have any questions regarding our use of your personal information please contact the Data Protection Officer, FremantleMedia Limited, 1 Stephen Street, London W1T 1AL or send an e-mail to Privacy.officer@fremantlemedia.com.  I'll let you all know how I get on.