Do you identify with a race other than your own?

Screaming Flea Productions, in conjunction with a Major Cable Network, is casting for a groundbreaking new series exploring Race and Identity. Whether you’ve been passing as a member of another race, or have been wanting to make the transition, we want to hear your story!

Applicant's Name:*
Applicant's Phone Number*
-
Applicant's Email Address*
Applicant's Age
Applicant's Occupation
Applicant's Address
Tell us a little about yourself! What do you do for work? What are some of your hobbies and interests?
What was your biological race at birth?
What race do you identify with now?
When did you first identify with another race? What prompted this change?
What steps have you taken, if any, to more fully participate in this race?
In what ways, if any, have you altered your physical appearance?
Do friends, family and coworkers know about your transition?
In what ways has your racial identity caused conflict in your life?
How are you able to overcome this conflict?
What else would you like us to know about your story?
Please attach 3-5 photos of yourself

CASTING APPEARANCE RELEASE:

I acknowledge that everything stated in this application is true. I further acknowledge and accept that this application form and any other materials (including, but not limited to, photographs, videotapes and applications) that I have submitted or will submit will become the property of Screaming Flea Productions, Inc. and will not be returned. By signing below, I hereby grant Screaming Flea Productions, Inc. the irrevocable right to use any biographical information contained in this application, home video, taped interview and any other materials submitted in any manner and for any purpose in all media now known or hereafter devised throughout the world in perpetuity without any additional compensation. Such rights shall include, without limitation, the right to record, use, publicize, distribute and otherwise exploit any video tape or taped interview, voice, actions, likeness, biographical information and appearance and any other material submitted in any manner and for any purpose in regards to the casting for the program currently entitled “Race & Identity” in perpetuity. I have all rights and permissions necessary to submit this application and grant the rights herein.

Type Full Name*
Date*
 / 
 / 
Type the characters below: