Millionaire Matchmaker Casting
ELECTRONIC APPLICATION INSTRUCTIONS:
1. To fill out this application electronically, please submit from a desktop or laptop computer. DO NOT USE AN IPAD OR IPHONE TO FILL THE APPLICATION OUT. It will not save and you will lose all of your work.
2. If not filling this out electronically, please fill out the application legibly, using dark colored ink. If you run out of space answering any question, please attach additional pages and reference the question(s) you are answering on such additional pages. Please write only on the printed side of the paper, but feel free to attach additional sheets if necessary.
3. You must fill out the entire application. Do not leave any question unanswered. If any question is not applicable to you, write N/A in the space provided, or if no space is provided, next to the question. Failure to answer any question may be grounds for not considering your application.
4. Complete and return this application ASAP, as we have a very limited amount of time until production begins. That said, PLEASE, take your time and answer completely and honestly.
PLEASE SEND ANY QUESTIONS REGARDING THIS APPLICATION TO firstname.lastname@example.org
Thank you for your time and effort and GOOD LUCK!
To be considered for this show, you must fill out this application honestly, accurately, completely, and to the best of your ability. Failure to do so may result in your elimination from consideration or from the show, as well as the forfeiture of any things you may have received, whether or not you have already received them.
Note: Throughout this application, you will be asked for contact information for various people. By listing a person, you are granting us permission to contact that person as a reference, as a means of contacting you, or as a means of obtaining additional information about you.
**NOTE** IF YOUR FORM WON'T ALLOW YOU TO SUBMIT, IT MEANS YOUR ANSWERS WERE TOO LONG OR PHOTOS ARE TOO BIG. PLEASE SHORTEN YOUR ANSWERS AND RESUBMIT.
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Cell Phone Number
Do you have an audition for Millionaire Matchmaker scheduled with us?
Do you have a Facebook Profile? If so, please give us the link.
Height: __________ Weight: __________ Eye Color: __________ Hair Color: ________
Have you ever been on the Program in the past? If so, did you go on a “master date”?
Where did you hear about our casting?
MILLIONAIRE? If you or anyone you know is a millionaire (minimum requirement is $1 million in assets) then you/they could qualify to be in Patti's club and get your/their own mixer. Please list their name and any contact info below or answer "YES, it's me!"
PART I: GETTING TO KNOW YOU (Please answer every question. Do not leave any questions unanswered or any space blank. If a question is not applicable to you, write N/A in the space provided, or, if no space is provided, next to the question.)
Have you ever been a member of the Millionaire’s Club or any other dating services? If Yes, which one and when?
Do you prefer to date men, women or both?
List each of the following 5 traits in order of importance for what you are looking for in a love match: looks, height, sense of humor, wealth, personality.
Have you ever dated someone you met online? If Yes, what attracted you to that person online before you met him/her?
What’s the longest relationship you’ve been in?
When did your last relationship end and why?
What’s your “deal-breaker” quality in a man/woman (based on your dating preference)?
What are your views on marriage?
Have you ever been engaged or married? If Yes, when did it end?
Do you have any kids? If not, do you want to have kids?
Do you have a “type” that you usually date or look for? If Yes, describe:
Who was your childhood celebrity crush?
“Most people I’ve dated say I’m too ______________________.”
Something I learned from my parents’ relationship: ___________________________________
“My ideal mate would be: ________________________________”
On a scale of 1-5 (5 being most competitive, and 1 being not competitive at all), how competitive are you?
On a scale of 1-5 (5 being very jealous, and 1 being not jealous at all), how jealous are you in a relationship?
“I want a mate to like me for my ________________________.”
Please list highest level of education and if college or junior college, any degrees or certificates earned and the name of the college/university where such degrees/certificates were earned:
Please list three things you like to do in your spare time:
True or False: “I believe in love at first sight”
Best date place/ ideal date:
“When I was little, I wanted to grow up to be a ____________________.”
Rate the following from 1 (not into it) to 5 ( love it!):
Outdoor activities (hiking, biking, etc.):
Fitness/ Working Out:
On Scale of 1-5, how neat are you? (1= I haven’t seen the floor of my bedroom in years, 5= I’m a neat-freak)
Save or Spend?
Passive or Aggressive?
Beach or Snow?
Tennis shoes or high heels?
What do you expect from this experience?
Why should we choose you above all other candidates?
PART II: THINGS WE MUST ASK (Please answer every question. Do not leave any questions unanswered or any space blank. If a question is not applicable to you, write N/A in the space provided, or, if no space is provided, next to the question.)
Are you a legal resident of the United States?
Have you applied to be on any TV shows in the past year? If yes, which one(s)?
Are you currently being considered for any other reality shows, including, without limitation, any game or contest shows? If YES, which one(s)?
Will you be appearing on any TV shows that are scheduled to air in the next year? If YES, which one(s)?
Have you ever acted, performed or appeared on television (including cable), film or stage?
If YES, please list the dates and shows:
Are you or have you ever been a member of the television/film unions SAG or AFTRA? If YES, please provide dates and details.
Do you know anyone else who is applying to be on “THE MILLIONAIRE MATCHMAKER”
(the “Program”)? If YES, please list their name(s) and address(es):
Not including your current residence, list the cities and countries you have lived in and state how long you lived in each place?
Have you ever been in the military? If YES, please list branch of Military, Dates of Service, AND Type of discharge.
(If YES, you will need to complete a form authorizing disclosure of your military records, including, without limitation, discharge papers, to the producers of the Program and please email a copy of your DD214 or any other discharge documentation.)
Were you ever the subject of any disciplinary proceedings or actions in the military? If YES, please describe in detail, including, without limitation, date(s), place(s), nature of charge(s), outcome of proceedings and any actions taken.
Have you ever been convicted of a felony or a misdemeanor? If YES, please give dates and details:
Have you ever been a party to a civil lawsuit? If YES, please describe when and where the event occurred, the other party (ies) to the lawsuit, whether you were the plaintiff or defendant, the nature of the case, and what the outcome was:
Have you ever had a temporary restraining order issued against you or has anyone ever attempted to obtain a temporary restraining order against you?
If YES, please give details, including, without limitation, date(s), place(s), name of party seeking the temporary restraining order and relationship of such party to you, and a description of the basis upon which the temporary restraining order was sought, whether it was issued, and the basis upon which it was issued.
Have you ever been convicted of any crime of reckless or drunk driving? If YES, please describe in detail, tell us when and where the event occurred, and what the outcome was.
Have you ever done or been involved in anything that would cause the Program producers and/or the cable network and affiliates that may exhibit the Program any embarrassment or monetary loss if you are chosen to participate in the Program? If YES, please list and explain the specific matters:
If you are 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, friends, family)? If YES, please describe, including your reasons:
Have you appeared in any magazines, publicly disseminated photographs, advertisements or on the Internet? If YES, please describe:
Have you ever created a website or posted any materials on any website? If YES, name and describe the website you created and/or the materials you posted.
Is there anyone among your family, friends or work colleagues that would object to you appearing on television? If YES, please identify all such persons, including your relationship with them and the reason they would object.
PART III: REFERENCES AND CONTACTS (Please answer every question. Do not leave any questions unanswered or any space blank.) Please remember to only list people in this section who you give us permission to contact as references or as a means to contact you.
Please list three people whom you frequently see in case we need to get in touch with you on very short notice or who can serve as a reference (i.e., significant other, roommate, boss, etc.): PLEASE INCLUDE NAME, ADDRESS, PHONE AND HOW YOU KNOW THEM
Please list three people who are not related to you and who have known you for over 3 years: PLEASE INCLUDE NAME, ADDRESS, PHONE AND HOW YOU KNOW THEM
Please attach a HEADSHOT of yourself.
Please attach a FULL BODY SHOT of yourself.
Thank you for your time and effort in completing the form.
You will sign a 'Certification of Veracity' if you come in for an interview stating that all of the information you have provided on this application is true to the best of your knowledge.
Please notify Producer in writing if there is a change in your address, phone number or other information provided by you in this application. If you come in for an interview, don’t forget to bring in your Driver’s License or government issued Photo ID and any military discharge records, if applicable.
Do Not Fill This Out