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Employment &

Contractor Information

v.091507

"I (named below) confirm the information provided below is truthful and accurate to the best of my knowledge and belief. I understand that no payments may be made by Experiencing Imagination until the information below and all required payroll and tax information is provided by me. I understand inaccurate or false information can result in delay of payment, reduction in allowable payment rate and termination of service. I understand a background check, police check and references check may be run and I authorize such action. I understand I must sign and submit a hard copy of this form."

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.)

 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:

Please check all boxes below that are true statements. Any boxes that you can not check, please explain in comments box below. Inability to check each box does not eliminate one from active status.

Below enter any degrees, licenses, certificates and special awards and/or honors held:

Below enter job experiences in last 10 years. Include employer company name, address & phone number, supervisor name and work assignment(s):

Below please explain why you would be suited for the position you are being considered for 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, provided appropriate answers are given. However, inaccurate answers will be reason for removal from consideration or future 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 agree not to compete with Experiencing Imagination or its successors during and for 24-months after ending employment.

Q05.

I have a valid, active driver's license and I have never had vehicle insurance cancelled.

Q06.

I have not been in a traffic accident or received more than 1 traffic citation in the last 3 years.

Q07.

I have never filed a workman's compensation claim.

Q08.

I have never been arrested for other than a minor traffic infraction.

Q09.

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.

Q10.

I agree to perform my work assignments efficiently and independently.

Q11.

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.

Q12.

I agree to the Company's Safe Sanctuary Policy for child abuse prevention found at http://www.earthtraces.info/forms/safesanctuary.shtml.

Q13.

I agree payroll and tax documents including 1099's and W-4 forms may be sent to me electronically by email, fax or other electronic method and this shall be equal to delivery by hand or postal mail.

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.com/employment/FORM-SP1.pdf.  

Within 5 days of accepting a salaried position, I agree to submit the following: (1) a digital photograph of myself suitable for publication in the Company's online staff reference guide; (2) a voided check from a checking account in my name where payroll payments will be direct deposited; and (3) --if applying for a position of Manager or higher--an updated personal resume. INCLUDE YOUR EMPLOYEE ID with each submission. (This is your first and last initials of your COMMON NAME --as you indicated near top above-- followed by the last 4 digits of your SSN.)

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: employment@TheEventLine.com.

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.

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