APPLICATION FORM

PLEASE READ THIS APPLICATION FORM, INCLUDING THE TERMS AND

CONDITIONS, VERY CAREFULLY BEFORE COMPLETING AND SIGNING.
Please fill out this application form legibly. If any question is not applicable to you, write N/A
in the space provided.
Return the completed Application Form, together with recent photograph of yourself,
ACCURACY OF INFORMATION PROVIDED
1.

You undertake that the information you give in this Application Form is correct, that
you accept the Terms and Conditions of entry as set out at the end of this
Application Form and that you meet each of the Eligibility Requirements as detailed
below.

2.

If any of the information you provide in this Application Form changes after you
submit the Application Form, you agree to promptly inform us of any such change.

3.

You acknowledge that, if we select you to appear in the Programme and you have
given false information on this Application Form, or fail to abide with the Eligibility
Requirements, or the Terms and Conditions, or any of our other reasonable
instructions or directions, then we shall be entitled to terminate your participation
in the Programme.

PROGRAMME ELIGIBILITY REQUIREMENTS

1.

You must be at least 16 (sixteen) years of age due to the scheduling requirements
of the Programme and the studio environment in which the Programme is recorded.

2.

You must be legally resident in any of SADC countries

3.

We have the right at our sole discretion to add to, delete from, modify or amend
these Eligibility Requirements and to select contestants for the programme. In all
circumstances concerning the interpretation and application of these Eligibility
Requirements, our decision will be final.

(The foregoing shall be collectively referred to as the Eligibility Requirements)

PERSONAL INFORMATION
Please attach a single recent photograph of yourself here and print your name on the back.
Please note that we are unable to return photographs. We see an enormous amount of
people at interview stage and a photograph helps the production team to remember
individual applicants.

Full Name
Preferred name
for use on the
Programme
Date of birth and
age
Address
Home Tel
Mob
Work Tel
E-mail
Do you have any
medical
conditions,
including any
disabilities, which
we should be
made aware of?

YES

NO

If you have answered yes, please specify details below and any special
requirements you may have for any studio appearance:

We will actively endeavour to accommodate any person with a

disability. Please detail any condition you might have that may
require our assistance. We require this information in order to
ensure that we meet our duty of care to you as a contestant,
including the provision of suitable access to audition and studio
venues.

Have you ever

been convicted of
a crime or are you
the subject of
ongoing criminal
proceedings or
investigations?

YES

Do you have any

County Court
Judgments against
you?

YES

NO

If you have answered yes, please specify below full details of any
conviction(s) or ongoing criminal proceedings/investigations (i.e. the
offences, the date of conviction, the court concerned and the sentence
imposed and any other relevant information).

NO

If you have answered yes, please specify details below.

If we later discover that you have criminal convictions you have

not informed us about previously, and as a result your
participation in the Programme is terminated or any prize or
benefit reclaimed or withheld, you accept that reference may be
made to these convictions publicly.
Is there any other
information we
should be made
aware of
concerning your
application
(including
anything in your
past that may
attract negative
press or
publicity)?

YES

NO

If you have answered yes, please specify details below.

Note: You must not withhold information from us of any material

fact that may in our reasonable opinion jeopardise or otherwise
impact on the Programme or which might result in publicity
adverse to our good name or the Broadcaster or the Programme
itself.
You agree that should you have anything in your past that may
attract negative press or publicity you will make us aware of it
in order to protect your personal interests, our reputation and
that of the Programme and the Broadcaster.

ABOUT YOURSELF
Children (names
and ages)
(Optional)
What is your
present
occupation?
(Please give
details)
What jobs have
you previously
had?

What
qualifications do
you have?
academic and
non-academic
qualifications)
Have you applied
for or appeared on
any other
television shows?

YES

NO

If yes, please list all television appearances (completed and pending as

is applicable) and give details, i.e. name of show, broadcast date,
channel and any prizes won all as is applicable.

Please give details

of any
hobbies/associatio
ns/
clubs
Please give details
of any special
interests or other
information which
you feel is
entertaining or
unusual
Where did you see
the advert for
Thrive Namibia

FOR OFFICE USE ONLY

HOW INFORMATION ABOUT YOU WILL BE USED

1.

Your personal data (Personal Data) means data, which relates to you, where you
can be identified directly from that data or from that data together with other
information in our possession.

2.

We may also use your information to verify your age, identity and other information
as we may require and to also carry out background checks with data handling
agencies, law enforcement and government agencies.

3.

If you are selected as a contestant for the Programme, your information may be used
in connection with the development, production and exploitation of the Programme.

4.

We may also use your information to deal with any questions or complaints arising in
relation to the Programme.
By completing and submitting this Application Form, you consent to the information
you provide being used for the above purposes.

5.

Please note that your refusal to grant us such permission will in no way influence
our selection process for this Programme.
If you are happy for us to retain the information you have provided in this Application Form
and which you may provide to us elsewhere during the selection process and/or during
production of the Programme for the above purposes, please indicate this by ticking the
relevant boxes below.
Use of all the
information you
have provided in
this Application
Form for any
future series of
the Programme.

Please only tick the box below if you would like all the information you
have provided in this Application Form and any information which you may
provide to us elsewhere during the selection process and/or during
production of the Programme (including your Personal Data and
Sensitive Personal Data)

Use of all the

information you
have provided in
this Application
Form for any
Other Show(s)

Please only tick the box below if you would like all the information you
have provided in this Application Form and any information which you may
provide to us elsewhere during the selection process and/or during
production of the Programme (including your Personal Data and
Sensitive Personal Data)

By returning this completed Application Form you confirm that:

(i)
(ii)
(iii)
(iv)

you comply with each of the Eligibility Requirements;

you have answered all the questions in this Application Form honestly and
truthfully;
you have read, understood and agree to the Terms and Conditions; and
you agree to the use of the information that you provide in this Application
Form and elsewhere during the selection process and/or during production of
the Programme (including without limitation your Personal Data and Sensitive
Personal Data) in accordance with the section How Information About You Will
Be Used above.

Signature:

(just name)

Print Name:
Date:

PLEASE COMPLETE THIS FORM AND SEND IT BACK TO US WITH A RECENT PHOTOGRAPH OF
YOURSELF VIA ONE OF THE FOLLOWING METHODS:
EMAIL TO: THRIVENAMIBIA@GMAIL.COM

The THRIVE Team