Mission Makeover
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BEFORE YOU APPLY

Applications will be accepted through June. Interviews will be scheduled in July. Your journey begins in August.

Mission Makeover is a reality TV show unlike any other...real women, real lives, real commitment, real solutions. It's a unique opportunity for a select few. Are you ready to take the ultimate journey to better health?

The moment of change starts now....

Your Mission, should you choose to accept it, will require the following:

"Mission Makeover" Requirements:

  • Attendance and participation in scheduled shoots. Punctuality is critical. (Shoots usually require 3 complete days per week and locations may vary across Miami-Dade, Broward, and Palm Beach counties. Flexibility is important as schedules may sometimes change.)

  • Follow supervised and unsupervised work-outs that do require a DAILY commitment.

  • Follow a designated nutrition plan and meal guidelines as dictated by our "Mission Makeover" experts. (Participants may be required to undergo medical exams as necessary.)

  • Follow and adhere to a designated nutrition plan and meal guidelines as dictated by our "Mission Makeover" Experts. This is NOT a "eat whatever you want" plan.

  • Participants will meet with our "Mission Makeover" Experts on a regular basis either by phone or in person. Experts include: Trainer, Nutritionist, Life Coach, etc.

  • Must have transportation to and from all required supervised work-outs and shoots.

  • Be comfortable sharing extremely personal insights and aspects of your life. This is critical to the success of your mission as well as the show. Our program will also focus on family dynamics.

  • Grant camera crews and producers access to your "personal space," including your home, outside activities, friends & relatives, and job IF reasonable.

  • Participants will be required to keep a journal and use social media platforms throughout the duration of the mission.

  • YOU, YOU, YOU must want this! It all starts and ends with YOU!

Eligibility Requirements

  • You must reside in or be willing to relocate to South Florida.

  • You must be 18 years of age or older, as of the date of your Application.

  • You must be a citizen or legal permanent resident of the fifty (50) United States and District of Columbia.

  • Please fill out this Application ('Application') legibly, using blue or black ink.

  • Answer all questions honestly and to the best of your ability. Do not leave any questions unanswered. If questions do not apply, write N/A as a response.
 


CONTESTANT APPLICATION: Mission Makeover Season 4


Health & Wellness TV, LLC ('Producer') is producing the television program series special titled 'Mission Makeover' ('Program').

PART 1: Personal Profile

First Name:

Last Name:

Email:

Addr 1:

Addr 2:

City:


Zip:

Home Ph#

Cell Ph#

Work Ph#

Other #

Website:

Date of Birth:

Height:
Weight:
Gender Select:

Marital Status (Check all that apply):
Single | Married
Divorced | Remarried
Widowed | Engaged
Check if you have children
Check if you are a legal resident

Spouse First Name:

Last Name:

Email:

Date of Birth:

Height:
Weight:

Employment


Child 1 First Name:

Last Name:

Email:

Date of Birth:

Height:
Weight:

Occupation


Child 2 First Name:

Last Name:

Email:

Date of Birth:

Height:
Weight:

Occupation


Child 3 First Name:

Last Name:

Email:

Date of Birth:

Height:
Weight:

Occupation


 


PART 2: Employment & Education History

Current Occupation:
Please note Full-time or Part-time employment.


Current Employer:


Highest Level of Education:
Are you currently in school, and if so, Full-time or Part-time? Online only?


School(s)/University Attended:


 


PART 3: Biography

Give us a brief bio on who you are, including work, family, kids, and living situation?


How much weight do you want to lose?


How does your weight affect all aspects of your life?


Why do you think you struggle with your weight?


How long have you been overweight?


What is your highest weight? When did this occur?


How much weight do you want to lose, and include your spouse and children?


Do you have any other family members who are also overweight?

If Yes, please list names and relationships:


Have you ever worked out with a personal trainer?

If yes, did you lose weight? How much weight? How long ago? Did you keep off the weight?


Are you currently working out? And if so, describe your workout routine.


How often do you work out? Are you a member of a gym? And if so, which one, and how often do you go?


How would you describe yourself in one word?


How would someone who knows you describe your best and worst qualities?


What is something about you that most people don't know?


What is your greatest accomplishment?


Please list a few hobbies, interests, activities or sports you enjoy?


What are your favorite restaurants?


Describe your favorite foods and or meals:


List all of the diets you have tried.


Have you gone through challenging life circumstances that have affected your weight?

If Yes, please include details:


List 5-10 things you want to do when you lose the weight?


What would motivate you to lose weight?


What are the things you have yet to experience because your weight has held you back?


What's the hardest thing about being overweight?


Have you ever had weight loss surgery (e.g., gastric bypass, lap band surgery, etc)?

If Yes, please include details:


Is there anything you won't cook or eat due to allergies or otherwise?


 


PART 4: Television Information

Have you ever acted, performed or appeared on television or film?

If Yes, please describe:


Are you or have you ever been a member of SAG/AFTRA?

If Yes, please include details:


Have you ever been on or tried out for any other reality television show?

If Yes, please include details:

Are you currently being considered for any other reality shows, including any game or contest?

If Yes, please include details:


If you have any obligations during the time period of September 2014 and May 2015, please list below:


 


PART 5: Medical History & Background

Do you currently have medical insurance?

If Yes, Medical Insurance Provider? Type of Insurance:

Do you smoke?

Comments:


Do you drink?

Comments:


Do you or anyone in your family have tattoos?

Comments:


Have you or a member of your family ever been treated for any serious physical or mental illness(es) or had any serious injuries?

If Yes, please include details:


Are you or a member of your family on any prescription medication that you take on a regular basis?

If Yes, please include details:


Do you or a member of your family have any allergies or medical conditions?

If Yes, please include details:


Do you or a member of your family have any physical conditions, special needs, or fears that we should know about?

If Yes, please include details:


Have you or a member of your family ever hit someone in anger or self defense?

If Yes, please include details:


Have you or a member of your family ever been arrested?

If Yes, please include details:


Have you or a member of your family ever had a restraining order placed against you?

If Yes, please include details:


Have you or a member of your family ever been charged with a crime (misdemeanor or felony), excluding traffic violations?

If Yes, please include details:


Have you or a member of your family ever been convicted of a crime (misdemeanor or felony), excluding traffic violations?

If Yes, please include details:

Have you now or have you ever owned or appeared on any web sites?

If Yes, please include the links below:


Do you know anyone else who is applying to be on the show?

If Yes, please give the name(s) and describe your relationship with them:


Have you ever been party to a lawsuit?

If Yes, please include details:


If chosen to be a participant on the Program, is there any person or part of your life that you would prefer not to share on camera (e.g., social organizations, activities, personal history, friends, family, etc.)?

If Yes, please explain below:


Who is the one person we could call as your character witness outside of your family? Please include name & phone #(s):


List your 3 closest male and female friends that we could call as character references. Please include their names and contact information:


Do you or your spouse suffer from hair loss or thinning hair?

If so, please explain the condition.


How did you hear about the casting call for Mission Makeover 4?


 


PART 6: Confirmation of Expectations


All filled out? Please review and confirm that you understand what is expected of you.


NEXT STEPS

After you fill out the questionaire, click the button below to upload a picture of yourself.

NOTE: Your application will not be reviewed unless you finish every step.

* For verification purposes only pursuant to 18 U.S.C. §§ 2256 et seq.