Urban Orchid Productions Cast Application
*Please complete this application in detail
*Applicants must be 18 or older to submit an application
*Applicants must be actively completing a doctoral program or have completed her program
*Applications are open to active members of the International PhD Sisters Association or PhD Sisters Group
CONTACT INFORMATION
Last Name *
Your answer
First Name *
Your answer
Address *
Your answer
Email *
Your answer
Phone *
Your answer
OTHER INFORMATION
Social Media Use *
Required
IPSA Member *
Required
GRADUATE SCHOOL
Graduate (Doctoral) School Name *
Your answer
School Address *
Your answer
Program/Major *
Your answer
Degree Type *
Ph.D., Ed.D, Psy.D., DBA, Ph.D. c. etc
Your answer
GPA *
Your answer
Completed Date or Expected Completion Date *
Your answer
Dissertation Title for Published Dissertation
Your answer
FAMILY LIFE
Are you in a relationship, single, engaged, married, widowed, divorced, or other? Explain: *
Your answer
How many years: *
Your answer
List all individual with whom do you live? *
Name (first and last, if different) | Relationship | Occupation | Age | Education (highest level obtained)
Your answer
GENERAL
Describe in detail your hobbies / interests / special skills ? *
Your answer
What three (3) words would your friends use to describe you ? *
Your answer
Why are you a perfect for this show? ( please be as detailed as possible ) *
Your answer
Do you consider yourself to be a leader or a follower? Give a detailed explanation of why this is true *
Your answer
What do you consider to be your greatest personal accomplishment *
Your answer
REALITY SHOW EXPERIENCE
Do you have any pre-existing health conditions that may hinder your participation on the show? If yes, please explain?
OPTIONAL
Your answer
Have you ever been arrested or detained by law enforcement whether you were charged or not? Please explain *
Your answer
How did you hear about our search for (doctoral) women to be on the show? *
Your answer
Have you participated in any television programs over the past 12 months whether they aired or not? If yes, please give details *
Your answer
List any special skills or talents?. *
Your answer
What types of episodes would you like to be considered for? IE: dating, cooking, competition, game shows, weight loss, other *
Your answer
What life experience sets you apart from others? *
Ex: Do you have a twin… are you adopted… were you raised by a single parent…do you have a large family…other?
Your answer
What are three things you’d like to do in life? *
Your answer
Do you have any regrets in life so far? Is so, explain. *
Your answer
What’s the most adventurous thing you’ve done. *
Your answer
Describe a typical day in your life. *
Your answer
Is there anything you would like to tell us that we did not ask about in this application? *
Your answer
I hereby represent and warrant as follows:
INITIAL HERE *
Your answer
(1) I am a legal US resident residing in the United States.
(2) I have accurately informed Producer as whether or not I am currently legally married and accurately identified my legal spouse, if any, to Producer;
(3) I have never have been convicted of a felony, and I have never had a restraining order or other injunctive relief entered against me. If I have been convicted of a misdemeanor, including without limitation traffic violations, I will advise Producer of such conviction(s).
(4) I am not, nor is any member of my immediate family (parents, siblings, children) or any members of my household (whether related or not), either currently employed, or have been, within the past year, employed by any of the the following entities or persons: URBAN ORCHID PRODCUTIONS or any, each of their respective parent, subsidiary, related and affiliated entities, or anyone involved in the development, production, distribution or other exploitation of the Series as well as immediate family/same household members of anyone so employed or involved, or known major sponsors of the Series or their advertising agencies.
(5) I have not appeared in a prime-time television reality /game show series and have not been involved in the current production of any such television series.
(6) I am not a candidate for public office and I agree not to become one until after one (1) year after the initial broadcast of the program in which I appear, if I am selected as a participant.
Additional Information
For good and valuable consideration (the receipt and sufficiency of which is acknowledged), I , hereby agree that you may use the information I have provided in my Casting Application and/or any other casting materials, my name, likeness (including, without limitation, my likeness on camera or in photographs taken by me, you or otherwise), voice, persona, biographical material, nickname, signature (original and telefaxed) and any other reproduction of my physical likeness (as the same may appear in any still camera photography and/or motion picture film or tape) (collectively, the “Casting Materials”) in and in connection with my potential consideration for future casting projects. (the “Projects”). You shall be the sole and exclusive owner of the results and proceeds of any Casting Materials, including but not limited to written applications, filming, taping, photographing or other recording conducted pursuant to this Release. I hereby release you from all liability and obligations to me of any and all nature whatsoever arising out of or in connection with the exercise of the rights granted above, including, without limitation, from any liability for violation of rights of privacy, publicity, defamation or any similar right. I agree that I shall be entitled to no additional consideration as a result of the exercise of the rights granted herein. I understand this Release is irrevocable. Accordingly, I hereby irrevocably waive any right to seek an injunction or other equitable relief in connection with the rights granted in this Release. I hereby agree to retain in the strictest confidence any and all elements relating to my involvement in the Projects, and all information, communications and materials (the “Confidential Information”) disclosed to or in any manner obtained by me throughout my participation in the Projects. I hereby acknowledge that the disclosure of any such Confidential Information will materially and adversely affect you and the Projects.
I understand and agree that all travel undertaken by me, if any, in connection with my eligibility for and participation in any project will be at my sole risk whether or not I am selected to be on the project. I understand and agree that I am solely responsible for obtaining and paying for any life, travel, accident, property or other insurance I may desire in connection with any travel and/or other activities I undertake on or in connection with the Project, and you are not responsible for providing such insurance. The word “you” as used herein shall mean Urban Orchid Productions and each of their affiliated companies, successors, assigns and licensees.
Urban Orchid Productions (UOP) is a private association. Cast members acknowledge and agree that “UOP”, it’s staff, volunteers, and any and all persons connected to the organization are hereby released and discharged from any and all liability, claims, and causes of action of any type whatsoever arising out of or in any way connected with participation with UOP and in all UOP sponsored events. “The UOP”, it’s staff, volunteers, and any and all persons connected to the organization makes no promise or guarantee of any product or service.

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Date *
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