A VICTORY TELEVISION PRODUCTION FOR ITV1

WHO WANTS TO BE A MILLIONAIRE?CONTESTANT APPLICATION FORM

Please read the application form carefully before completing and signing.

You are applying to be considered as a contestant in ITV’s WHO WANTS TO BE A MILLIONAIRE? which VICTORY TELEVISION intends to produce for initial transmission by ITV (the “Broadcaster”). The show requires contestants to take on the hot seat and attempt to answer 12 questions to win the £1 million prize.

Please fill out the application form legibly, using a clear black font.

Deadline for applications is: Monday 7thAprilbut we reserve the right to extend the closing date and time at our sole discretion.

You mustfill out the entire application form. Please do not leave any question or section unanswered.

Please complete the application form, attach a recent photograph of yourselves and return by e-mail to:

We will be calling and inviting successful individuals for an audition butplease do not contact us for any feedback.If you do not hear from us, you have not been successful this time.

Many thanks for applying to be on the show.

PROGRAMME ELIGIBILITY REQUIREMENTS

  1. You must be aged at least 18 (eighteen) years of age due to the chance for contestants to win a cash prize.
  1. You mustbe resident and currently living in the United Kingdom.
  1. You are not employed by us or any of our group of companies, affiliates, subsidiaries, agencies or persons professionally associated with the Programme and/or the Broadcaster and/or the provider of the Prize, or be sufficiently connected with the Programme (for example a live-in partner or immediate relative of an employee of ours or the Broadcaster) such that your participation in the Programme could create the appearance of impropriety, unless otherwise approved by us.

The foregoing shall be collectively referred to as the “Eligibility Requirements.”

You hereby undertake that the information you give in this application form is correct and that you meet each of the Eligibility Requirements as detailed above as well accepting the terms and conditions of entry which are set out at the end of this form. If any of the information you provide in this application form becomes incorrect between the date of this application form and the date of our decision as to whether you have been selected to go forward to the next stage of the selection process, you agree to inform us immediately of the nature of any such change. You hereby acknowledge that in the event we select you to appear in the Programme and you have given false information on this application form or fail to comply with the Terms and Conditions or any of our other reasonable instructions or directions, then we shall be entitled to terminate your participation in the Programme.

PERSONAL INFORMATION

Full Name:
Preferred name for use on the Programme:
Date of Birth and age: / We endeavour to have as diverse a range of contestants appearing on the Programme as possible, including contestants of varying ages.
Family Status (Single/Married with Kids etc)
Address:
Home Tel:
Mob:
Work Tel:
Can you accept phone calls at work?
E-mail:
Do you have any medical conditions that the production team should be made aware of, including any disabilities? / Yes / No
If you have answered “yes” please specify details below (including any special requirements you may have for any audition or studio appearance):
We require this information in order to ensure that we meet our duty of care to you as an auditionee or a contestant, including the provision of suitable access to audition and studio venues.
Have you ever been convicted of a crime or are you the subject of ongoing criminal proceedings? If yes, please give details.
Do you have any County Court Judgments against you? If yes, please give details.
PLEASE NOTE: That if you progress further in the application process, we reserve the right to carry out background checks on you to verify the above information. Furthermore, disclosure of criminal convictions, current criminal proceedings and/or county court judgments may not automatically exclude you from participating and we shall be entitled to exercise our discretion on this point but in all cases our decision shall be final.

EMPLOYMENT AND QUALIFICATIONS

What is your present occupation? (Please provide a description of your job)
What qualifications do you hold (educational, academic, vocational professional etc.)?

ABOUT YOURSELF

How would your friends describe you?
Tell us what you enjoy doing in your spare time? (Hobbies, collections, interests, clubs)
Please tell us an interesting fact about yourself.
How well do you cope under pressure?

PROGRAMME SPECIFIC QUESTIONS

What are your strongestquiz subjects?
What are your weakest subjects?
How competitive are you on a scale of 1-10?
Have you applied for or appeared on any other television shows? / Yes / No
If you have answered “yes”, please give details (including without limitation all television appearances whether completed and pending (as applicable) of the name of the show(s), nature of your participation, recording date, broadcast date, channel, any prizes won and any other information as you see fit)
PLEASE NOTE: If you progress further in the application process, we reserve the right to carry out background checks to verify the above information. Please be honest here, appearances on other shows and previous winnings will not exclude you from selection
If you won £20,000 on the show what would you spend your winnings on?
How would £250,000 change your life?
Do you have any unfulfilled ambitions in life?
Tell us why you’ve chosen to apply for Live Who Wants To Be A Millionaire?

AUDITIONS

If you were invited to an audition which of the following cities would be preferable for you? (Please tick or mark preference) /
  • BELFAST [ ]
  • BIRMINGHAM [ ]
  • CARDIFF [ ]
  • GLASGOW [ ]
  • NEWCASTLE [ ]
  • LONDON [ ]
  • MANCHESTER [ ]

AVAILABILITY

Filming of the show is scheduled to take place in July. Are you fully available during the first two weeks of this month?

DATA RETENTION

We would like to keep the information you provide in this application form for future related use when, for example, producing a further series of the Programme or other similar programmes. We would like to keep the information for two years. If you do not consent to this it will not influence our decision in the selection process for this Programme. Please tick the appropriate box to indicate your preference / YES, I WOULD LIKE THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE RETAINED SO AS TO BE CONSIDERED FOR ANY POSSIBLE FUTURE SERIES OF THE PROGRAMME OR OTHER SIMILAR PROGRAMMES
1. [ ]
NO, I DO NOT WANT THE DATA SUPPLIED ON THIS APPLICATION FORM TO BE CONSIDERED FOR ANY POSSIBLE FUTURE SERIES OF THE PROGRAMME OR OTHER SIMILAR PROGRAMMES
1. [ ]

1

By returning this completed application form you confirm that:

(i)you have read, meet and agree to be bound by each of the Eligibility Requirements;

(ii)you have answered all the questions in this application form honestly and truthfully; and

(iii)you have read, understood and agree to the terms and conditions at the end of this form and the programme recruitment terms and conditions available at We may ask you to sign additional documents or agree to additional terms and conditions as the process continues and failure to do so may result in disqualification from the process.

IF YOU ARE RETURNING THIS FORM BY E-MAIL THEN BY PRINTING YOUR NAME YOU ARE AGREEING TO THE ABOVE TERMS AND IF YOU ARE ASKED TO ATTEND AN AUDITION WE WILL ASK YOU TO SIGN AND RE-DATE THIS FORM IN PERSON.

Signature Applicant: (if emailing form type in name):
Print Name:
Date:

Remember, please complete this form and send it back to us with a recent photograph of yourselF:

email to:

Deadline for applications is: Monday 7thAprilbut we reserve the right to extend the closing date and time at our sole discretion.

MANY THANKS FOR TAKING THE TIME IN APPLYING TO BE ON THE SHOW AND GOOD LUCK!

VICTORY TELEVISION

TERMS AND CONDITIONS

The following terms set out the agreement between you and us for your application as a contestant on the Programme (this “Agreement”).

1.GENERAL

  1. These terms and conditions (the “Terms and Conditions”) relate to your application to take part in the Programme which we propose but do not undertake to produce for the Broadcaster, and form part of your Application Form.
  1. Neither we nor the Broadcaster are liable to refund any costs or expenses incurred in applying to participate in the Programme, or in participating in the Programme, including but not limited to the costs of calls made, postage, ISP charges, telephony fees, travelling expenses, transportation, accommodation, meals, drinks, insurance, taxes and other costs unless otherwise agreed in writing by us.
  1. We and our subcontractors do not accept any responsibility whatsoever for any technical failure, malfunction of or any other problem with any computer network, system, server, provider, telephony system or otherwise or for any postal service failures which may result in any application not being properly received.
  1. You agree that any application forms which are incomplete or incomprehensible, incorrectly addressed, lost in transit, containing insufficient postage, not received by us at the relevant postal or email address or sent in after any specified closing date may not be considered.
  1. You accept that, due to the large number of applications we receive, we will not acknowledge or respond to each and every application but only to those of successful applicants. We will review your application and shall decide which applications are suitable to be put forward to the next stage of the selection process. You accept and agree that contestants will be selected at our sole discretion, that such decisions shall be final and that there will be no right of appeal against any decisions taken by us on this matter.
  1. You accept that receiving an application form and/or a phone call from a member of the Programme production team and/or attending an audition and/or attending any recording days DOES NOT automatically mean that you will be appearing on the Programme and we reserve the right, at our sole discretion, to stand you down at any time during the production process, even if you have been given a date to attend auditions or recordings.
  1. We do not represent, undertake or warrant that we will produce or broadcast any episode of the Programme or to include any applicant’s participation.

2.YOUR OBLIGATIONS

  1. You agree to abide by the rules and regulations of the Programme as shall be notified to you in writing or verbally. You accept that such rules and regulations may be varied by us from time to time and that our decisions in this matter are final.
  1. You agree to attend any auditioning processes, heats and promotional activities relating to the Programme if required by us on any dates as shall be notified to you.
  1. You agree to undertake a medical and/or psychological assessment, conducted by a certified practitioner, if so required by us.
  2. You warrant that you comply with each of the Eligibility Requirements above and, if required by us, you agree to provide us with documentary evidence as well as providing all consents and assistance in carrying out any background searches if so required by us to substantiate the information provided in this Application Form.
  3. You warrant that nothing in this Application Form will:
  1. infringe the copyright or any other right of any third party;
  2. breach any contract or duty of confidence;
  3. constitute a contempt of court or expose us to any civil or criminal proceedings; and/or
  4. otherwise be intended to bring us or any other party into disrepute.
  1. You warrant that you have truthfully and accurately completed this Application Form and agree that we may in our sole discretion disqualify you from any stage of the Programme auditioning and selection process or the Programme itself at any stage if:
  1. you supply or have supplied any untruthful, inaccurate or misleading details and/or information;
  2. you fail to abide by the rules and regulations of the Programme;
  3. you otherwise deceive us about your identity;
  4. you fail to abide with any of our other reasonable instructions or directions; and /or
  5. you are otherwise in breach of any of these Terms and Conditions or the programme recruitment terms and conditions at itv.com/terms
  1. You agree that you will not withhold information from us of any material fact that may in our reasonable opinion jeopardise or otherwise impact on the Programme or which might result in publicity adverse to our good name, the Broadcaster or the Programme. You agree that should you have anything in your history that would make for negative press or publicity you agree to make us aware of it in order to protect your public interest and our reputation and that of the Broadcaster.
  1. You agree to notify us of any changes to the circumstances and/or information and/or data provided in this Application Form, including any criminal charges and/or convictions which are brought against you, during your continued participation in the Programme selection process.
  1. You agree to indemnify us and our assigns and licensees against any and all claims, losses and/or damages suffered directly or indirectly by us as a result of the breach, non-performance or non-observance by you of any of your obligations and representations under this Agreement.

3.INTELLECTUAL PROPERTY RIGHTS

  1. In the event that you are invited to attend an audition and any other subsequent stages of the Programme selection process, you agree and consent to the filming and recording of your voice, conversation and sounds, including any performance of any musical composition(s), during and in connection with your application for the Programme (the “Contribution”) and the use of your Contribution in the Programme in whole or in part or not at all.
  1. You irrevocably grant and assign to us any and all copyright and other rights, title and interest in your Contribution so as to permit the fullest use throughout the world of the Contribution or any part(s) thereof by all means and in all media in connection with the Programme or otherwise in perpetuity. For purposes of clarity, you accept that we have the right to edit, copy, adapt or translate the Contribution as we see fit and you irrevocably waive the benefits of and agree not to assert any provision of law known as "moral rights" or any similar laws of any jurisdiction.
  1. You further agree that any photographic material(s), video material(s) and/or any other materials you have submitted as part of your application to appear as a contestant in the Programme and/or as part of your Contribution (collectively referred to as the “Submission”) may be featured in the Programme and you warrant that you have the necessary licences, rights, consents and permissions to authorise us to use your Submission in full or in part.
  1. You grant us a worldwide, perpetual, royalty free and transferable licence (with the right to sub-licence) to use, edit, record, modify, translate, distribute, make available to others, prepare derivative works of and exploit your Submission by any medium or method whether now known or later developed throughout the world for the full term of copyright and other rights and all renewable and extension thereof. You irrevocably waive the benefits of and agree not to assert any provision of law known as "moral rights" or any similar laws of any jurisdiction in respect of the Submission. You agree to provide us with details of all such licences, rights, consents and permissions relating to the Submission if we so request.
  1. For the avoidance of doubt, you agree that we have no obligation whatsoever to return any materials (including without limitation, the Submission) which you have submitted as part of this application whether or not you are selected as a participant and that we are in no way obligated to use any such materials in connection with the Programme.
  1. You hereby grant us the right to use your name, voice, likeness, photographs and any biographical material concerning you in connection with the promotion and exploitation of the Programme and/or ancillary products/services and/or in connection with us and/or the broadcaster of the Programme, throughout the world in all media in perpetuity.

4.DATA PROTECTION

  1. The personal information you provide to us will be used to assess whether or not to select you for the Programme and you agree that we may share your information with the Broadcaster of the Programme as part of the selection process. If you are selected as a contestant, you agree that your information and data may be used in connection with the production and exploitation of the Programme. You further accept that that we may pass on your personal information to a regulator or governmental authority including without limitation the Information Commissioner and/or OFCOM should it be requested from us. You consent to us retaining your data for the purposes of complaints, further programmes (if you have indicated your consent in the Application Form) and as otherwise specified herein and consent to us sharing your data with professional advisors and/or ITV plc group companies as is necessary.
  1. You agree and accept that we may use the information you have provided in this Application Form to verify your age, identity and other information as is deemed necessary and to carry out background checks with data handling agencies, law enforcement and government agencies.
  1. By completing and submitting this Application Form, you consent to any sensitive personal information that you provide (for example, information relating to your health or to criminal convictions) being used for the purpose of assessing your suitability for the Programme and, if your successful, for the production of the Programme.
  1. Unless you agree we can use your data for future shows, we will use your data only for the purpose of processing your application and producing this show. We may share this data with third parties including without limitation broadcasters and regulators.

5.CONFIDENTIALITY