CONTESTANT APPLICATION FORM

Attach /
Email
First Name: VENKATESAN__________________ Middle Name________________ Last
Recent
NameBOOPALAN__________________ Photograph

Age as on 1st October 2009 __19___________ Gender (M / F):______M____________________________

Address: ___NO:92/31,BUTCHAMMAL STREET, NEW WASHERMEN PET,CHENNAI –

600081.________________________________________________________________________

__________________________________________________________________________________

City: _____________CHENNAI____________________ State:

______TAMILNADU____________________________________

Contact number (M)___9840876330_____________________

(R)____04425916682__________________(O)______________________

Language Spoken: ____TAMIL__________ /_ENGLISH_____________ /______________

/______________/______________

E-mail:__venkat_b_engineer@yahoo.co.in_______________________________________

1) What levels of education have you completed (please specify school and major):
High School, Some College, Professional Degree, Bachelors Degree, Masters Degree, Doctorate.
______HSC(COMPUTER SCIENCE) ,K.C.SANGARALINGA NADAR HIGER SECONDARY SCHOOL
___________________________________________________________________________________

_________________________________________________________________________________________

2) Who is your current employer and occupation? (What job pays your bills now?)

_________STUDYING_B.E.(COMPUTER SCIENCE) MADRAS INSTITUTE OF TECHNOLOGY,ANNA

UNIVERSITY_______________________________________________________________________________

_________________________________________________________________________________________

3) Please list your last three jobs:

A:____________________________________________ B: _________________________________________

C: _______________________________________________________________________________________

4) Please circle those that apply: Married, Separated, Boyfriend / Girlfriend, Single, Engaged
SINGLE

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How long have you been in your current relationship?
________________________________________________________________________________________

5) What would your friends say are your best qualities?

___GOOD BOY , SOCIAL SERVICE
_____________________________________________________________________________________

6) What would your friends say are your worst qualities?

____SHORT TEMPER
____________________________________________________________________________________

7) What is your unique and personal motivation for wanting to be on the show?

________MY MOTHER NEED A SMALL OWN HOUSE.THE AMOUNT WHICH I GOT FROM THIS SHOW
GOES TO MY MOTHER
________________________________________________________________________________

8) What is the next milestone in your life if you do not make it to the Show?

________________________________________________________________________________________

9) Describe your most embarrassing moment:

________________________________________________________________________________________

________________________________________________________________________________________

10) What is the weirdest / unique thing about you?

________________________________________________________________________________________

11) What is your idea of a dream vacation?: ____________________________________________________

________________________________________________________________________________________

12) What makes you a great contestant for ‘Deal or No Deal’ (“Show”)?

_________MY FATHER AND FRIENDS ASK ME TO PARTICIPATE IN THIS SHOW. MONEY DOESN'T
MATTER_______________________________________________________________________________

________________________________________________________________________________________

13) Besides the Show, what game show would you be the best contestant for and why?

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____JACKPOT BECAUSE I LIKE QUIZ
PROGRAM____________________________________________________________________________________

14) List all TV game/talk/reality shows/contests which have already aired or which may air
within the next
year, on which you have appeared, and whether or not you won any prizes. If you have NOT
appeared on
any such shows, please state this. Do not leave the space below blank.

Show Name Air Date Amount Won

NIL NIL NIL

NIL NIL NIL

15) Below please list the people you would like to appear with you on the show to help support
you:

Supporter #1:

Name :
____BOOPALAN.K_____________________________________________________________________

Telephonel # : ______25916682
___________________________________________________________________

Supporter’s relationship to
you:_____FATHER______________________________________________________

Why do you want this Supporter with you on stage? ____ENGOURAGE

ME______________________________________

Supporter #2:

Name :
____VIJAYALAKSHMI.B_____________________________________________________________________

Telephone # :
____25916682_____________________________________________________________________

Supporter’s relationship to
you:___MOTHER________________________________________________________

Why do you want this Supporter with you on stage?MOTIVATED ME TO PARTICIPATE IN THIS
SHOW ___ _______________________________________

Supporter #3:

Name : ___GOVINDARAJ.B
______________________________________________________________________

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 Telephone # :
__9884117554_______________________________________________________________________

Supporter’s relationship to you:__ELDER

BROTHER_________________________________________________________

Why do you want this Supporter with you on stage? ______ENGOURAGE

ME____________________________________

Please list any additional supporters you may wish to appear with you on camera
(along with the same
information asked above) on the back of this page.

16) Have you ever been charged/accused with any crimes?

______NO__________________________________

17) If YES, please describe in detail, tell us when and where the event occurred, and what the
outcome was including FIR/Case
numbers:__NO____________________________________________________________

18) Have you ever been convicted in any crimes?

____NO____________________________________________

19) If YES, please describe in detail, tell us when and where the event occurred, and what was
the sentence /
punishment:_____NO_____________________________________________________________________

20) Is there any pending litigation against you? __NO_______________. If YES, please describe
when and where

the event(s) occurred, the other party (ies) to the lawsuit(s), whether you were the plaintiff
or defendant,

the nature of the case(s), and what the outcome was for each
case_______________________________

______________________________________________________________________________________

______________________________________________________________________________________

21) Is there anyone among your family, friends, or work colleagues that would object to your
appearing on

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 television? YES NO (Circle One). If YES, please identify all such persons, including your
relationship

with them and the reason they would

object.________________________________________________

_____________________________________________________________________________________

Please read, sign and date the following acknowledgement:

I warrant and represent that I am above 18 years of age.

I agree and accept that in the event of any death or injury or bodily harm caused to me at the
time of auditions/ shooting of any episode of the Show/ Program, Endemol India Private
Limited and Sun TV Network Limited shall not be responsible for the same.

I agree that the selection will be at the sole discretion of Endemol India Private Limited and
Sun TV Network Limited and it is understood by me that the rules are subject to changes
without any notification.

I hereby acknowledge that: (i) I have read the Terms and Conditions attached herewith and
agree to be bound by the same and the eligibility requirements; (ii) I have answered the
previous questions honestly, completely and accurately; (iii) if any of the above information is
found to be false or incomplete, this will be grounds for dismissal from the selection process for
the Show, and/or from the Show itself, if selected. Further Endemol India Private Limited and
SUN Network Limited reserve the right to change/ modify the terms any time without any prior
intimation.

Name: Signature:

Date:

Place:

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