Initial entry form for Take me Out

SABC1 is producing a hot new dating show, Take me Out. If you are looking for Mr or Ms Right, this is where to enter. If we like what we see in this first entry form we'll send you the full form to fill in and, who knows, you may end up as a contestant on Take me Out. Mzansi fo Sho!

Q.1
First things first! Load us a recent picture of yourself. Remember, no picture, NO ENTRY!! *

Browse to the location of the photo on your PC/phone and send the picture to us.

Q.2
Where do you live? *

Give us only the suburb and town/city where you live.

Q.3
Leave us your name and surname in the fields below *


Q.4
Are you a guy or gal? *

Q.5
What is your ID number? *

Q.6
Leave us your phone numbers so we can contact you *

Q.7
Give us the e-mail address we can contact you on *

Q.8
What makes you tick *

What do you look for in a date? What are your interests? What is your idea of a romantic evening? What is your choice in music? Do you like sport, music, dancing or clubbing? This info will help us to find you that BIG date if you become one of our show contestants.

Terms & Conditions:

By submitting this form I declare that the above information is correct and I hereby electronically sign the form. I also acknowledge that I have read the Terms and Conditions .

Q.9
Do you agree to the terms and conditions and give permission for the SABC or its agent/s to contact you?? *

We undertake to contact you regarding your entry into the Take me Out TV show only . We will not share your information with anyone else.

Created at Crowdsignal.com