SATURDAY NIGHT TAKEAWAY APPLICATION.Docx

NOMINATION FORM - ANT AND DEC’S SATURDAY NIGHT TAKEAWAY

A NOTE FROM TEAM TAKEAWAY:

Dear Nominator,

Thank you for your interest in Saturday Night Takeaway - we’re so excited you want to get involved in our 2014 series. It’s going to be amazing!

We’re busy in the office devising lots of exciting ways to surprise your nearest and dearest. All we need now is for you to nominate them.

As you well know, Saturday Night Takeaway can surprise people anytime, anywhere and we can make things happen that no one else can. We could give your friend or family member the Saturday night of their life and a once in a lifetime experience!

Below is the nomination form. This our first chance to get to know both you and whoever you are nominating.

Remember – you can nominate more than one person. It could be one person, a couple or even an entire football team!!

We know there are lots of questions but please persevere – the more you fill in, the more we get to know about them - and the better the chance of them being chosen. PLEASE GIVE US AS MUCH DETAIL AS POSSIBLE.

Please provide as many photos as you can – it really helps us build a full picture of your nominee. If you need more space for your responses, please feel free to add at the end of your application.

Saturday Night Takeaway is full of different kinds of surprises and items. This is a general application form and we will consider your nominee for all of them!

If we want to move forward with your application, we will be in touch to ask you further questions. Sadly unsuccessful applicants will not be contacted.

Remember – a surprise only works if it’s a surprise! So please keep your nomination a secret! Especially from the person you are nominating.

Thanks for taking the time and hopefully we’ll be speaking to you soon!

Very Best Wishes,

Team Takeaway

PS: Please fill this form in as quickly as possibly – the quicker we hear from you, the quicker we can get started! NOMINATION FORM - ANT AND DEC’S SATURDAY NIGHT TAKEAWAY (SERIES 11) (THE “PROGRAMME”)

PLEASE READ THIS NOMINATION FORM, INCLUDING THE TERMS AND CONDITIONS REFERRED TO, VERY CAREFULLY BEFORE COMPLETING AND SIGNING. ***YOU ARE REQUIRED TO KEEP THIS NOMINATION A SECRET AT ALL TIMES***

ELIGIBILITY REQUIREMENTS:

In order to participate in the Programme neither you nor the Nominee(s) can be: a. currently employed by ITV Studios Limited (“we”, “us”, “our”), the ITV group of companies or the holders of the OFCOM Channel 3 licences (which at the time of writing and for the purposes of this Nomination Form consist of ITV Broadcasting Limited, Channel Television Limited, STV North Limited, STV Central Limited and UTV Limited and any successor or replacement licensees) (with the foregoing licence holders collectively referred to as the "Broadcaster") and have not been previously employed by us, any of the ITV group of companies or the Broadcaster; or b. a live-in partner or immediate relative (i.e. mother, father, son, daughter, brother or sister) of an employee of ours or the Broadcaster or any of the ITV group of companies.

(the foregoing shall be referred to as the “Eligibility Requirements”)

YOUR INFORMATION (We need your details even though you are nominating someone else. If you are under 18, please arrange for a parent/legal guardian to complete this form on your behalf)

Full Name:

Date of Birth:

Address:

Contact Numbers: (Home / Work / Mob)

E-mail (NOTE: this must be a private e-mail address for contact with you only)

Occupation:

When is the best time to contact you?

How did you hear about the Programme?

PLEASE GIVE DETAILS OF SOMEONE WHO IS WILLING TO ACT AS A REFEREE IN RESPECT OF YOUR NOMINATION

Please give us the name of a referee to verify your NOMINATION. The referee must be aged 18 or over. This can be a friend, family member or work colleague but they should know both yourself and the nominee.

REFEREE: Full name

Contact Numbers: (Home / Work / Mob) Relationship to you:

DETAILS ABOUT THE NOMINEE (THE PERSON YOU ARE NOMINATING TO BE ON THE SHOW)

If it is a group of people that you are nominating, then please state how many people in total and the details.

The person you are nominating MUST be over 18 years old.

Note: With regard to any information we request of you in this Nomination Form which relates to the Nominee(s) please only provide information you feel the Nominee(s) would agree to you passing on to us. If there is any question, which you feel the Nominee(s) would not agree to you providing information to us on, please tell us next to the relevant question.

Nominee(s) full name:

Nominee(s) date of birth:

Nominee(s) address:

Telephone of Nominee(s):

URL link to their Facebook / Twitter pages

Nominee(s) occupation:

Are there any dates between January and April 2014 you know they would not be able to appear on the show? (Eg: a holiday)

How do you know your Nominee(s)?

Describe their family life:

Eg: do they have children and what are their ages? Where do they live? Do they have a partner? If so, what does their partner do? FURTHER QUESTIONS ABOUT THE NOMINEE(S)

PERSONALITY Feel free to use MORE THAN ONE EXAMPLE in each section – the more we know, the better!!

How would you describe their personality? The more info you can give, the better!

How would they react to being surprised on live television?

What is the naughtiest thing they have ever done which they’ve kept secret?

Eg: Have they ever bought their partner a ring from the market and pretended it was more expensive?

What is the naughtiest thing they have ever done which people know about?

Eg: bumped their mum’s car and got found out.

Are they a practical joker?

If so, what sort of jokes have they played? Please attach any related photos.

What is the most outrageous or funny thing they have done? At work / on holiday / out shopping / on a night out.

Do they have any funny dating / romance stories?

Any other funny stories about this person? ANYTHING!!

HOBBIES, INTERESTS Fill in your answers below AND TALENTS

What are their main hobbies?

Do they have any quirky collections or interests?

Do they have any special talents or party tricks?

Eg: can they do an impression of someone famous? Do they have a weird or amusing skill?

Were they funny or talented as a child?

Eg: Were they mad on magic or musicals? Please attach related photos if you have them.

Who are their 5 favourite 1. celebrities? 2.

Have they ever been a Super-Fan of anything, either now or in the past?

Eg: do they have a tattoo of Robbie Williams or did they name one of their kids after a Spice Girl?

Do they have any embarrassing habits?

Eg: collecting their toe nail clippings

Have they had any fashion disasters? Eg: hilarious hairdos, outrageous outfits.

Please provide photos if available.

Do they have any funny social media habits?

Eg: do they always Tweet celebrities? Do they post pictures of their dinner on Facebook. Have they uploaded anything to YouTube?

What would be their ultimate dream come true?

WORK & SPARE TIME Fill in your answers below

What does their job involve?

What hours do they work? Do they work Saturdays? Please give specific times where possible.

How do they usually spend their Saturday nights?

Eg: karaoke, in the pub, watching TV, etc. Who do they usually spend their Saturday nights with?

How do they spend their free time and evenings generally?

How do you think the Nominee would react to being surprised? Have you even seen them surprised?

SPECIAL OCCASIONS Fill in your answers below

Do they have any special events coming up between now and summer 2014?

Eg: birthdays, weddings, christenings, baby showers, graduations, parties, sporting events, retirement – literally any big events in the diary.

The more exciting dates we know about, the better!!

Have you or they ever been on TV before? If so, please specify the show and when it was aired… PHOTOS:

Please attach a photo(s) of yourself and the Nominee(s) to this Nomination Form. The more interesting and dynamic the photos, the better!!

TERMS AND CONDITIONS:

By submitting this Nomination Form, you hereby agree to be bound by the Ant and Dec’s Saturday Night Takeaway Series 11 Nomination Terms and Conditions detailed at: http://www.itv.com/termsconditions/competitionsandvotes/?oid=569&type=tcs&origin_type=tcs&origin_oid=all

(the “Terms and Conditions”)

WHAT TO DO NEXT:

Please make sure that you have completed ALL SECTIONS of this Nomination Form and email it back to us attached with recent photographs of both yourself and your Nominee(s) by email to: [email protected] or by post to: Ant and Dec’s Saturday Night Takeaway, The London Television Centre, Upper Ground, London, SE1 9LT (Note: Please be aware that if you do send photos by post, we will be unable to return them.)

By returning this completed Nomination Form you confirm that:

(i) you have answered all the questions in this Nomination Form honestly and truthfully; and (ii) you have read, understood and agree to the Terms and Conditions.

Signature (if emailing this form, type in your name):

Print Name:

Signature of parent / legal guardian (if under 18):

Print Name: