Rebuilding Love - Contestant Application Form

Thank you for your interest in participating in "Rebuilding Love." Please complete the application form below. All information provided will be kept confidential and used solely for the purpose of selecting contestants for the show. By submitting this application, you agree to undergo a background check if selected.

Name

First Name

Last Name

DOB (Must be 21 or older)

YYYY

Gender

Preferred Pronouns:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Social Media Handles

Occupation & Education

Employer (if applicable):

Highest Level of Education Completed:

Field of Study (if applicable):

Relationship Background:

Have you been married before?

If yes, how many times have you been married?

Do you have children?

Describe your dating history in a few sentences:

Why Do You Want to Be on "Rebuilding Love"?

What are you hoping to gain from your experience on the show?

Describe your ideal partner in 3-5 sentences.

Health & Background Information:

Do you currently use any medication?

Do you have any dietary restrictions?

Have you ever been convicted of a crime?

If yes, please provide details:

Consent for Background Check:

please re-copy and paste it by filling your name in the blank, then sign your full name below: By signing below, I, [_________________________], authorize SoSo Legit TV to conduct a background check, which may include criminal records, past employment, and other verifications. I understand that my application will be disqualified if any information is found to be inaccurate or misleading.

Sign your name

Date

YYYY

Additional Information:

Describe yourself in a few sentences.

Is there anything else you would like us to know about you?

Photo Upload

Please attach a recent photo of yourself (Headshot): Please attach a full-body photo: Note: By submitting this application, you consent to the use of your photos for casting purposes.

Rebuilding Love - Contestant Application Form

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