Personal Information First Name: Address: Last Name: City: Middle Initial: State:     Zip: - Home Phone:   Work Phone: Are you over 18 years of age? Yes No Email Address:     Desired Employment Information Have you ever been employed by Tuacahn? Yes No If yes, Month and Year: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 20032004200420052006200720082009201020112012201320142015201620172018 If yes, which department: Position Desired: Concessions Box Office Lighting Crew Sound Crew Set Crew Costume Crew Props Crew Stage Manager House Manager Maintenance Custodial Other - Please explain in skills section below. Pay Expected: Are you available for full time work? Yes No If not, what hours can you work? Will you work overtime if asked? Yes No Are you legally eligible for employment in the United States? Yes No Special training or skills (Languages, machine operation etc.): When will you be available for work? JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 12345678910111213141516171819202122232425262728293031 / 2013201420152016201620172018 Prior Education Information Type of Education: High School College or University Business/Trade or Technical school Number of Years Completed: School's Name: Did you Graduate: Yes No School's Location: Degree or Diploma:     Emphasis: Employment History Information Company Name: Job title and description of work: Telephone: Address: Start Date: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 12345678910111213141516171819202122232425262728293031 / 20032004200420052006200720082009201020112012201320142015201620172018 Reason for leaving: Supervisor's Name: Starting Pay: May we contact this employer: Yes No Ending Pay: If no, reason for not contacting:   Company Name: Job title and description of work: Telephone: Address: Start Date: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 12345678910111213141516171819202122232425262728293031 / 20032004200420052006200720082009201020112012201320142015201620172018 Reason for leaving: Supervisor's Name: Starting Pay: May we contact this employer: Yes No Ending Pay: If no, reason for not contacting:   Company Name: Job title and description of work: Telephone: Address: Start Date: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 12345678910111213141516171819202122232425262728293031 / 20032004200420052006200720082009201020112012201320142015201620172018 Reason for leaving: Supervisor's Name: Starting Pay: May we contact this employer: Yes No Ending Pay: If no, reason for not contacting:   Company Name: Job title and description of work: Telephone: Address: Start Date: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / 12345678910111213141516171819202122232425262728293031 / 20032004200420052006200720082009201020112012201320142015201620172018 Reason for leaving: Supervisor's Name: Starting Pay: May we contact this employer: Yes No Ending Pay: If no, reason for not contacting: Please copy the characters from the left into the field below. (Case Sensitive)   The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If Tuacahn decides to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.