First Name:
Last Name:
Nickname (if any):
City, State:
E-Mail and Instant Message contact information:
Gender:
Age:
Date of Birth:
What is your current occupation?
Name three of your favorite hobbies.
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List three adjectives that best describe yourself:
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What is your favorite music to listen to?
If you watched the American Survivor, or read the first season of Shuffled which contestant did you like most and least, and why?
List three (3) items you would take with you to the remote location, if allowed and why?
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What skills do you bring to Shuffled that would make you a useful member of the group?
What types of people would you choose to have with you on Shuffled?
What types of people would you choose NOT to have with you on Shuffled?
Why do you believe that you could be the final Survivor?
Are you available to be a contestant in a future Shuffled program if you are not selected as a contestant in this Shuffled season?
Have you participated in any other online reality games?
If so, what was the result?
Please write a biography about who you are and what you like to do: