EMPLOYMENT INFORMATION SUBMISSION

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Independent Part-Time
Contractor Information

v.120707

PLEASE USE THIS ONLINE APPLICATION TO SUBMIT INFORMATION ABOUT YOURSELF SO YOU MAY BE SCHEDULED TO WORK EVENTS FOR EXPERIENCING IMAGINATION, INC.

"I, (named below) confirm the information provided below is truthful and accurate to the best of my knowledge and belief. I understand inaccurate or false information can result in delay of payment, reduction in allowable wage rate and termination of service. I approve any methods of verification of information desired by Experiencing Imagination, Inc."

Please provide the following information:

(Please avoid giving yahoo or similar email addresses - these web-based email systems often fail when we try to send you files. Also, make sure your email server doesn't reject mail from TheEventLine.com.)

Please highlight any region you wish to work in.

MULTIPLE SELECTIONS ALLOWED. Transportation to job sites or the Company warehouse serving event is your responsibility:

Please highlight any region you wish to work in. MULTIPLE SELECTIONS ALLOWED. Transportation to job sites or the Company warehouse serving event is your responsibility:

Full Legal Name (for Payroll):

Full Common Name (that you want to be called):

Full Street Address (payments sent here):

Your City, State, Zip Code:

Permanent E-mail Address:

Home Phone Number:

Cellphone Number (if available):

Driver's License # and State of Issuance:

Date of Birth (format = MM/DD/YYYY):

Social Security # as will appear on W-2 or 1099:

In the box below please enter any degrees, licenses, certificates and special awards and/or honors held:

Below enter job experiences or references. When possible, include company name, address & phone number, supervisor name and work assignments:

Below please explain why you would be suited for a position at Experiencing Imagination and why clients would accept you as a representative of the company:

Below please click the check boxes below to answer the questions accurately. If you are unable to check a box, please explain this in the dialog box following the questions. You will still be considered for employment even if some boxes are unchecked, just provide additional information in the box provided at the end. Inaccurate or dishonest answers will be reason for removal from consideration and/or dismissal.

Q01.	I agree this application shall be binding as long as I receive any wage from Experiencing Imagination or its successors.
Q02.	I understand and agree to Form SP-1 "Employment Service Policy" now and as it may change in the future. I agree to the STAFF POLICY (Form SP-1) as it may be updated from time to time. I understand and agree to its non-compete, non-interference and intellectual properties provisions.
Q03.	I agree my acceptance of any wage confirms my acceptance of the then current Form SP-1.
Q04.	I have a valid, active driver's license and I have never had vehicle insurance cancelled.
Q05.	I have not been in a traffic accident or received more than 1 traffic citation in the last 3 years.
Q06.	I have never filed a workman's compensation claim.
Q07.	I have never been arrested for other than a minor traffic infraction.
Q08.	I do not use drugs or alcohol illegally or to excess. I do not use drugs or alcohol illegally. I agree to any drug testing required by Company policy.
Q09.	I agree to perform my work assignments efficiently and independently.
Q10.	I will submit a digital picture and resume (when required). I understand I must provide a copy of my driver's license and a completed IRS W-4 form before any payment may be made to me.
Q11.	I agree to the Safe Sanctuary Child Abuse prevention policy found at http://www.TheEventLine.info/forms/safesanctuary.shtml.

I agree to print, sign and return a copy before performing any work assignments for the Company. I understand payments and reimbursements to me may be delayed until this is completed.

I understand that I may review and/or download a copy of FORM SP-1 at: http://www.TheEventLine.info/employment/FORM-SP1.pdf.

Below, please provide an honest, fair and complete explanation of any items above that you did not check. Begin each with its question number ("Q1, Q2...Q10") so it may be quickly cross-referenced. If none, type "NONE".

Any communications should be directed to: .

Under the penalties of perjury, I confirm the accuracy of the information above and my agreement with it.

Date:___/___/20__	Signature: ___________________________________________
PLEASE PRINT, DATE, SIGN AND RETURN A HARD COPY OF THIS FORM TO YOUR AREA DIRECTOR. KEEP A COPY FOR YOUR RECORDS.