Contestant Application Form

CONTESTANT APPLICATION FORM

ATTACH YOUR PHOTO HERE You must attach a recent photograph of yourself which you feel best reflects your personality.

Can you answer TV’s toughest general knowledge questions? Fifteen to One is more than just a quiz! It’s a demanding test of knowledge, a tense game of strategy and an enthralling contest.

A REMEDY PRODUCTION FOR CHANNEL 4

‘Fifteen’ contestants start the game, but only ‘One’ can win. Have you got what it takes to compete for the title of Fifteen to One Champion!

Please complete this form and send it back to us with a recent photograph via email to: [email protected]

or post it to:

Fifteen to One Contestant Applications, The Hub (Unit G1), 70 Pacific Quay, Glasgow, G51 1DZ

IMPORTANT – PLEASE BE AWARE OF THE FOLLOWING:

 If the application and photo are larger than 5MB it will not reach us.  The email address to send completed applications to ([email protected]) is different to the one you emailed to receive an application form.  You can only apply once so please only send one completed application form. Note: successful applicants will be granted one audition only. CONTESTANT INFORMATION

FIFTEEN TO ONE APPLICATION FORM Version –03/08/2017 – Series 9 2 Full Name on Passport: Name you would like to go by for the show: Age and D.O.B (you must be over 18): Address:

Home Tel:

Work Tel:

E-mail:

Job: (please give a short description)

Previous Employment:

Availability: Please state any dates that you are NOT available for filming from Sunday 22nd October to Monday 13th November 2017 and Thursday 18th January 2018 to Saturday 3rd February 2018.

1. Why would you like to appear on ‘Fifteen to One’?

2. What are your hobbies and interests? (Please include groups/clubs that you belong to and tell us about any awards, funny moments or other achievements)

3. List your 3 general knowledge strengths and weaknesses.

Strengths Weaknesses 1. 1.

2. 2. FIFTEEN TO ONE APPLICATION FORM Version –03/08/2017 – Series 9 3 3. 3. TV APPEARANCES

Have you appeared on or are due to appear on any other television shows? If yes, please list all television appearances in date order and give details below. Being on past/future TV shows will not preclude you from appearing on Fifteen to One. However, should you appear as a contestant on this series of Fifteen to One you agree not to appear on any other television shows, subsequent to those listed below, until this series has been broadcast.

You must keep us informed of any other TV shows you are featured in, up to the point of the recording of the episode(s) of this series of Fifteen to One in which you are featured.

Failure to provide complete and accurate information on this part of your application may result in Remedy reconsidering your contribution to the production.

Name of Show Broadcast Date Channel Prize Won (if applicable) **EXAMPLE** Who Wants to be A 08/11/2011 ITV £1 Millionaire

CONTESTANT DECLARATION HOW INFORMATION ABOUT YOU WILL BE USED

1. Personal information which you supply to Remedy (including but not limited to information about your health and any previous criminal convictions, cautions or charges) will be used in a number of ways, for example: ● in selecting potential contributors for the Programme ● to assess whether you are a suitable contributor in relation to the Programme ● to develop, produce and publicise the Programmes and ● (if you are selected to participate in the Programme) to broadcast and distribute the Programme and exploit all allied and ancillary rights including but not limited to video, DVD, online, books and magazines ● (if you are selected to participate in the Programme) we will enter your email address into a system called Silvermouse whereby you will be invited to provide, and may do so at your option, your diversity characteristics. 2. We will not publish your address or contact details.

3. Your personal information will be shared with members of the Programme production team and relevant staff at the broadcaster of the Programme.

4. Remedy will ensure that any information provided for the purpose of producing the Programme will be used in accordance with the Data Protection Act 1998.

5. All information will be kept secure and treated as confidential and will only be disclosed with your permission (including any permissions you give here or in the rest of the application process). In submitting this application form you are consenting to us using your personal information as set out in this section.

FIFTEEN TO ONE APPLICATION FORM Version –03/08/2017 – Series 9 4 6. You have the right of access to the information held and used by us. If at any point you decide that you want to update your contact details please email us at fifteentoone dataprotection@ remedyproductions.tv 7. Unless you specifically agree to be contacted by us your personal information will not be used for any other direct commercial purposes including direct marketing. Remedy would like to retain this application form for future related use, for example, possible future series of Fifteen to One, or when producing similar programmes. Please note that if you agree to this, you may be contacted separately by Remedy or its parent company, subsidiaries and affiliates and you agree that Remedy may pass information to its parent company, subsidiaries and affiliates for this purpose. Your information will be held for a maximum of 24 months from the date of your recording. Your refusal to grant us such permission will in no way influence our decision as to whether or not we further your application to appear on this series of Fifteen to One.

Please tick the box if you are happy for Remedy to keep your details on file □

If you do not consent to future use of your information and you are not selected to participate in the Programme your application form will be securely destroyed once the Programme has been completed.

If you are selected as a contestant for the programme your personal information will be kept securely by us during the production process and for a reasonable time thereafter and always in accordance with Data protection rules.

TERMS AND CONDITIONS

By signing this application form (or printing your name if returning by email) you hereby agree to the following terms and conditions (please note that if you return this application by email and you are contacted by the Producer to attend an audition or interview, you will be required to sign a copy of this form):

1) ‘Programme’ shall mean all versions of ‘Fifteen to One’

2) that you are aged eighteen (18) years or over and a resident of the United Kingdom, the Channel Islands or the Isle of Mann and have a current United Kingdom, the Channel Islands or the Isle of Man address that you are not employed and have not been previously employed or engaged by Remedy Productions Ltd (“Remedy”) or Argonon Group Ltd (and all its subsidiary and affiliates) or Channel 4 and you are not a live-in partner or immediate relative (i.e. mother, son, daughter, brother or sister) of an employee of Remedy Productions Ltd or Argonon Group Ltd (and all its subsidiary and affiliates) or Channel 4 or any of their agencies associated with “Fifteen to One” (“The Programme”);

3) you agree and confirm that if you are selected to participate in the Programme you shall abide by all the rules of the Programme (as may be amended or supplemented from time to time) and shall accept that Remedy’s decision(s) in respect thereof as final and binding (including all decisions by Remedy concerning selection of the participants) and I agree not to challenge or appeal against those decisions;

4) that you understand that any compensation received as a result of your appearance in the Programme (if selected to participate and whether received from Remedy or third parties) may affect my entitlement to any governmental benefits that you may otherwise be due to receive. You understand that if you are receiving benefits, it is your responsibility to consult the relevant authority for further clarification;

5) that you have answered all of the questions on the application form fully, honestly and accurately and confirm that you have not misled or attempted to mislead the Producer in any way as to your identity, experiences or in any other way. You agree to keep the Producer informed of any change to these circumstances or the information and/or data set out in this application form. If you are found to have knowingly supplied inaccurate, misleading or false information, you understand Remedy will be entitled to exclude you from the ‘FIFTEEN TO ONE’’ selection process, and if you have already taken part in the Programme you may be required to forfeit any prize you may have won;

6) If you are shortlisted, you agree to authorise Remedy to conduct background checks in order to verify any of the information you have supplied and you agree to provide Remedy with any assistance or further information necessary to do this and to provide to Remedy any documentation as requested for the purpose of verifying the information that you have provided to Remedy in the application form or otherwise (including providing all consents and assistance in carrying out any police background searches required by Remedy);

7) that you will supply proof of valid identity in the form containing a photographic such as a Passport, Driving Licence or a government approved photo ID (such as a citizen card) and where such valid ID does not detail a residential address you agree to also provide additional proof of address.

8) that you own all rights in the photograph that you have submitted with this application form and that Remedy and Channel 4 shall be entitled to copy, edit and/or otherwise use the same at their sole discretion for the purposes of making, selling, promoting, and exploiting the Programme and any other programme or promotional material connected with it in all media;

FIFTEEN TO ONE APPLICATION FORM Version –03/08/2017 – Series 9 5 9) not to discuss any information concerning Remedy, the Programme or your possible participation in it, with any other person or company, whether by means of discussion, letter, press, social media (i.e. Facebook, Twitter or any other forms of social media) and television interviews or otherwise, at any time without the prior written consent of Remedy;

10) to the processing of your personal data for the purpose of considering your application, for administration, production and exploitation of the Programme and for related services, in accordance with the Data Protection Act 1998 and other applicable data protection legislation and the provisions of this application form.

11) to be available at such times and locations as Remedy shall reasonably require; and that Remedy has no obligation to produce the Programme and even if the Programme is made there will be no obligation on Remedy, Channel 4 or any broadcaster to broadcast it. All decisions by the Producer concerning selection of the participants are final and I agree not to challenge or appeal against those decisions.

12) All applicants will be required to disclose if they have ever been convicted of a criminal offence or have any criminal prosecutions pending or been the subject of an official police caution before taking part in the Programme. If the information you give to Remedy at any time about your prior convictions, pending police or judicial actions, suspended criminal proceedings or cautions is found to be false and/or misleading Remedy will be entitled to exclude you from any further participation in the Programme or the Programme selection process;

13) If you are selected to appear on the Programme and any information you have provided about your prior convictions, pending police or judicial actions, suspended criminal proceedings and/or cautions is found to be false and/or misleading your entitlement to the money or prizes won on the Programme (if any) shall be forfeited and Remedy may in its sole discretion withhold the money/prizes won and/or require you to repay any money already paid. If you are not happy with this, then please don’t continue with your application;

14) UK Broadcasters are researching diversity on their productions. This covers diversity characteristics you choose to tell the broadcasters about and also how viewers might perceive diversity on screen. If you provide us with your e-mail address, we will enter this in a system called Silvermouse. You will be invited to provide, and may do so at your option, your diversity characteristics – gender, ethnicity, disability, age, gender identity and sexual orientation. The broadcaster, as data controller, is responsible for the data and will have access to reports compiled from it for purposes of the research. Further information can be found here: http://creativediversitynetwork.com/diamond-contributors/

I agree that I have read and understood the terms and conditions and the information contained within this application form and I understand that all information given by me in this application form (save for address and contact details) may be used in the Programme should I be selected. I understand that once this application form has been submitted no subsequent changes will be accepted by Remedy (save as may be required to update your contact personal details).

CONTESTANT SIGNATURE

Signed: ...... Date:…………………………..

Name (please print) ………………………………………………………………

Please complete this form and send it back to us with a recent photograph via email to: [email protected] or post it to: Fifteen To One Contestant Applications, The Hub (Unit G1), 70 Pacific Quay, Glasgow, G51 1DZ

Unfortunately, photographs or documents sent cannot be returned so please don’t send any photographs that you are not happy for us to keep on file.

Please note that due to the anticipated high volume of applications, unsuccessful applicants will not be contacted. Finally, we cannot guarantee to audition everyone that applies and due to the volume of response we cannot acknowledge receipt of your application. If you are invited to attend an audition, please note that we are unable to reimburse travel expenses to and from auditions. We would also like to state at this stage that receiving an application form, an audition date or a phone call from a member of the production team DOES NOT automatically mean that you will be appearing on the programme and we reserve the right at any time to stand down a contestant, even if you have been given a recording date. Good Luck! Thank you for taking the time to complete this application form.

FIFTEEN TO ONE APPLICATION FORM Version –03/08/2017 – Series 9 6