Nominate a Friend for Losing it with Jillian Michaels

If you are nominating someone other than yourself, please complete this page first and help the person you are nominating complete the rest of this questionnaire. The person you are nominating will need to be a willing participant in the process in order to be considered.

IMPORTANT NOTE: You will need to meet the eligibility requirements for the series and sign additional documents, which may include a participant agreement, if you are selected as a potential participant for the series. Submitting information to us does not guarantee a response. We have no obligations to you based on our receipt of information from you. The video, the application, and any other materials you submit will become our property and will not be returned to you, whether or not you are selected as a participant. Please note that due to the overwhelming volume of submissions we are not obligated to respond to you or to acknowledge acceptance of your video submission, application, or any other materials that you submit.

Your Information
Nominee's Information
Background Information

In your opinion, what is holding you or this family back or what is the cause of their current crises?

We’re looking for deserving candidates that America can root for.