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Shipwrecked
Shipwrecked Shipwrecked Shipwrecked

So you want to be Shipwrecked? If you are 18-23 years old and can make yourself available from the end of July - December 2005 then all you have to do is fill in the application form, attach ONE photo and get it back to us as soon as possible.

You could find yourself being picked from thousands of entries and could have the opportunity of a lifetime ahead of you..

Applications must have a photo sent with them in order to be considered.

It will also help your Application if you send in a short VHS (up to 5 mins) telling us why you should be shipwrecked!

These and any photos that you can't upload can be sent to us at:

Shipwrecked,
RDF Media
The Gloucester building
Kensington Village
Avonmore Road
London W14 8RF

(Please make sure anything sent is clearly labelled with your full name and telephone number)

Shipwrecked
First Names:
Surname:
Street:
Town:
Postcode:
Telephone:
Email:
Date of Birth:
Height: ft in
Weight: st lb
Marital Status:
What is your sexuality?
Where did you hear about Shipwrecked?
Can you be available to be shipwrecked from end of July - December 2005? Yes No
What is your job and what does it involve?
If currently unemployed, describe your daily routine?
What do you do in your spare time?
Education/qualifications (these aren't important, we're just curious!)
Have you travelled much? If so where have you been? Or will this be your first time abroad?
If you could change anything about your life, what would you change?
What are you most passionate about?
Can you swim? Yes No
Do you smoke? Yes No
Do you have any medical conditions/allergies? Yes No
If 'Yes' please explain:
Do you hold a criminal record? Yes No
Do you have any phobias?
How would friends describe you?
What would be the hardest thing about being shipwrecked for 5 months?
What would you be giving up for this experience?
Why do you think we should shipwreck you?
Have you been on tv before? Yes No
is there anything else you want to tell us about yourself?
Remember, sending a VHS (up to five minutes) of yourself will help your application. Will you be sending in a VHS? Yes No

Please send your photos to:
shipwrecked@channel4.co.uk
Please clearly state your name on the email to guarantee entry

Please note:

1) Photos and videos will not be returned.
2) By completing and returning this form you confirm that you are happy for the information you provide to be retained by RDF for use in connection with the programme.
3) By completing and returning this form you confirm that you are willing to be considered for other programmes RDF may produce and these details may be retained for this purpose in accordance with RDF's privacy policy which can be found at www.rdfmedia.com/privacy




Shipwrecked

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