Name:
Address:
Home:
School:
Phone:
Home:
School:
Email Address:
Birthday:
Age:
Parent:
Names:
Phone Number:
Addresses:
Sisters / Brothers:
Names:
Have you ever been a member of SAG/AFTRA? (circle one) Y N
Have you ever acted outside of school? (circle one) Y N
Name of High School and years completed:
Name of College and years completed and Major:
Other Education:
Are you currently in school: (circle one ) Y N
Do you Work? If so describe your job:
What will you miss the most about leaving your friends and family for 10 weeks?
What will you miss the least:
How would you describe your best traits?
How would you describe your worst traits?
Have you ever treated someone in a way that made you proud? Tell us about it.
Have you ever treated someone in a way that you regret? Tell us about it.
How long does it take you to get ready in the morning? Do you consider your self high maintenance? Why?
If you could take one back pack for the trip, what would you bring?
Describe your most embarrassing moment.
Do you have a Girlfriend/Boyfriend ? (circle one) Y N
How did you meet?
How would she/he feel about you being gone for 10 weeks:
Other than your boyfriend or girlfriend, who is the most important person in your life right now? Describe him or her and why he/she is important.
How important is sex to you?
Do you have it in only when you are in a relationship or do you seek it out at other times? What is the most exciting/interesting place you’ve has sex?
Is there any issue, political or social, that you’re passionate about? Have you done anything about it?
What is the most important issue or problem facing you today?
Are you physically fit?
Do you work out? If so, how often and what types of activities do you like to do? If not, how do you stay in shape?
Describe a major event or issue that has effected your life:
What habits do you have that we should know about?
What habits do other people have that you simply cannot tolerate?
Describe how conflicts were handled at home as you were growing up (Who won? Who lost? Was yelling/hitting involved).
What are your thoughts on abortion?
On sexual orientations different from your own?
On welfare?
Where was you born? Where did you grow up?
Have you traveled around the United States? Describe some experiences you have enjoyed:
And some you didn’t:
Tell us some places in the United States you have always wished you could visit and why?
What do you do the weekend for fun?
If you had Aladdin’s lamp and three wishes, what would they be?
Name three people that you would like to meet and why?
Where do you see yourself in five years (personally and professionally)?
Ten years?
What is the last unusual, exciting or spontaneous outing that you instigated for you and your friends?
Do you smoke? (circle one) Y N
Do you drink alcohol? How old were you when you had your first drink? How much do you drink now? How often?
Do you use recreational drugs? What drugs have you used? And how often?
Are you on any prescription medication? If so, what and for how long have you been taking it?
Have you ever been arrested? If so, what was the charge and were you convicted?
Have you had any traffic tickets? If so how many?
Has your license ever been suspended? If so, why?
Do you believe in God? Are you religious? Do you practice religion?
Who are your heroes and why?
When you do something ridiculous, how much does it bother you to have other people notice and laugh at you?
How would you rate on the following?
(Rate yourself on a 1 to 10 scale, 1 being unskilled and 10 being very skilled)
Activity Rating Comments
Riding a bicycle
Riding a motorcycle
Skiing
Running a mile
Snowboarding
Rock climbing
Surfing
Speaking a foreign language
Fixing a car
Fixing a motor
Fixing a flat tire
Cooking
Sewing
Tying nautical knots
Sailing a boat
Swimming
Skydiving
Water-skiing
Using a computer
Driving a bus
In-line skating
Bungee jumping
Setting up a tent
Reading a map
List 4 people that have known you for a long time and will tell us what a great person you are (excluding relatives)
Name Address Phone How long have they known you?
1.
2.
3.
4.
I acknowledge that everything stated in this application is true. I understand that any falsely submitted answers can and will be grounds for removal from the application process and from subsequent participation in the final series. I further acknowledge and accept that this application form and the video tape I summit to MTV and will become property of MTV and will not be returned. By signing below, I grant the rights for MTV-Bunim/Murray Productions (BMP) to use any biographical information contained in this application, my homevideo, or taped interview, voice, actions, and likeness, and appearance in manner in connection with ROAD RULES.
Signature:______________________________
Date: ___________________
Send to:Bunim-Murray Productions
6007 Sepulveda Boulevard
Van Nuys, CA 91411