Are you being held back by heartbreak? Is your past dictating your future? Are you stuck in a rut? Does your world seem populated by lots of happy couples... and then there's you?
Heartbreak Hotel is a new TV3 show that helps people struggling to move on from a break up. If chosen, you'll be taken to a retreat. While there, a combination of expert coaching and a plan tailored to your break up story and your life will be designed to start you making the move from surviving to thriving. Are you ready?
Heartbreak Hotel is a chance to hit the reset button and start the rest of your life. Every journey starts with a single step and a trip to Heartbreak Hotel is the first. The size of that step? Well, that's up to you.
Your details
Full Name:
Mobile Number:
Email Address:
Age:
Profession:
Have you availability to film in October? Yes No
More about you:
How long have you been single for?
Why do you think your relationship ended?
Why are you finding this relationship so difficult to move on from?
Have you dated since the break up? Yes No
What steps have you taken to try to recover?
Do you have contact with your ex?
Why do you feel taking part in the show would be beneficial to you?
What would you hope to gain from the experience?
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