Full Text
APPLICATION FOR EMPLOYMENT CITY OF FARMINGTON SANDSTONE PRODUCTIONS 901 Fairgrounds Rd. Farmington, New Mexico 87401 TELEPHONE: (505) 599-1150 Position ____Actor\Performer\Technician PLEASE READ THIS BEFORE FILLING OUT THE APPLICATION FORM A new application must be submitted for each position for which you are applying. Resumes are not accepted in lieu of an application, but may be attached for supplemental information. The completed application may be submitted to the Sandstone Productions Business Office at 901 Fairgrounds Road. This application form is an important part of the employment process. Candidates for any position may be eliminated based on an evaluation of the application. Please type or complete in ink as neatly and clearly as possible. Answer all questions to the best of your knowledge. You may provide as much detail as you wish by adding extra sheets of information or a resume. False, incomplete or inaccurate information is cause for disqualification or discharge. PERSONAL INFORMATION Last Name: First: Social Security Number: (Optional) Present Mailing Address: State: Zip: Street Address (if different from above): City: State: Zip: Telephone: (Message/Cell) Do you have a valid Drivers License? Driver's License State: Class: Expiration Date: Email GENERAL INFORMATION Yes No Have you ever been convicted of a Felony? If "yes", on a separate sheet please give date(s) and place(s), the specific charge(s) and fully explain the situation. A conviction is not necessarily a bar to employment. Can you work legally in the United States? (If hired, documentation showing eligibility for employment in the United States and identity will be required.) Have you ever been employed by the City of Farmington? If "yes", on a separate sheet please give date(s), job title(s).department location(s) and reason(s) for separation. When would you be available to start work? May we contact your present employer about your work? May we contact your previous employer(s) about your work? List any other name under which you have been employed. APPLICATION MUST INCLUDE A RECENT PHOTO OR HEADSHOT IF AUDITIONING. ---PAGE BREAK--- School Name and Address of School Course of Study Last Year Completed Did you Graduate List Diploma or Degree High School College College Other Specify MILITARY SERVICE RECORD Have you served in the U.S. Military Service? EMPLOYMENT EXPERIENCE List below all present and past employment beginning with your most recent. If you held more than one position with the same employer, please list each position separately. FILL OUT INFORMATION COMPLETELY. IF MORE SPACE IS REQUIRED ATTACH RESUME OR ONE ADDITIONAL SHEET. DO NOT WRITE SEE RESUME. ACTING EXPERIENCE: PLAY ROLE YEAR PRODUCING ORGANIZATION 1. 2. 3. SINGING/DANCE EXPERIENCE: Please indicate or for each role PLAY ROLE YEAR PRODUCING ORGANIZATION 1. 2. 3. TECHNICAL EXPERIENCE: PLAY ROLE YEAR PRODUCING ORGANIZATION 1. 2. 3. STAGE COMBAT EXPERIENCE: PLAY ROLE YEAR PRODUCING ORGANIZATION 1. 2. 3. Do you certify that you are available for rehearsals beginning May 13, 2013 and all performances beginning June 20, 2013 and ending August 3, 2013, technical positions will be required until August 10, 2013? Yes or No Specify any and all dates that you will not be available: Scheduling conflicts with the rehearsals and productions could jeopardize your being cast in the 2013 production. All rehearsals and performances are mandatory, other than any dates listed above. Failure to attend will result in personnel action. ---PAGE BREAK--- Other Licenses or Certifications (if required for the job): Profession Trade: Level: Expiration Date: M/D/YYYY Issued by: Any offer of employment may be made contingent on applicant passing a job related physical examination and drug test. If any of your relatives are employees or elected officials of the City of Farmington, please list their name and family relationship to you: Name Department Relationship Name Department Relationship EMERGENCY CONTACT: Name Address Phone AGREEMENT AND CONSENT 1. I certify that these answers are true and correct to the best of my knowledge. 2. I UNDERSTAND THIS APPLICATION IS SUBJECT TO VERIFICATION. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN. I understand that misrepresentations or omissions of fact in this application will be sufficient cause for disqualification or dismissal from employment with the City of Farmington if I have been employed. I agree that the City of Farmington will not be held liable in any respect if any employment offer is not tendered, is withdrawn, or my employment is terminated due to false statements and answers in this application. I understand and agree that this application is an initial application. I understand that additional information may be required of me. I further understand and agree that this paragraph applies to any information supplied by me at a later date as part of this application. 3. I hereby acknowledge that I have read and agree to the above statement. SIGNATURE DATE We consider applicants for all positions without regard to race, color, religion, sex, National origin, age, disability, or any other legally protected status. We are an Equal Opportunity Employer The City of Farmington is a Drug and Alcohol Free Workplace