PLEASE USE THIS ONLINE APPLICATION TO SUBMIT INFORMATION ABOUT YOURSELF SO YOU MAY BE SCHEDULED TO WORK EVENTS FOR EXPERIENCING IMAGINATION COMPANIES, INC ("THE COMPANY").

THE COMPANY does not discriminate based on age, religion, race, sex or national origin.

"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 THE COMPANY"

Please provide the following information:

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:

ATLANTA, GA CHICAGO, IL COLUMBIA, MO KANSAS CITY, MO SPRINGFIELD, IL SPRINGFIELD, MO ST. LOUIS, MO NASHVILLE, TN TOPEKA, KS ANYWHERE (WILL TRAVEL)

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:

EVENT SUPPORT EVENT TECH CASINO DEALER

Full Legal Name (for Payroll) (FIRST/MI/ LAST):

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

Full Street Address (payments sent here):

Your City, State and Zip Code:

Your Permanent E-mail Address:

Home Phone Number:

Cellphone Number (if available):

DO NOT PROVIDE INFORMATION IN THIS SHADED AREA UNTIL HIRED

NON-HS GRADUATE HS GRADUATE ASSOCIATES OR TECH DEGREE COLLEGE DEGREE

In the box to the left, please indicate your level of education.

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

NONE UNDER 3 YEARS 3-5 YEARS 6-10 YEARS OVER 10 YEARS

In the box to the left, please indicate your years of work experience.

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

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 detailed any lost time injuries I have had in the past and how they may or may not impact my performance with THE COMPANY.

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 THE COMPANY.

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 am not listed on any sexual offender list and agree to the Safe Sanctuary Child Abuse Prevention Policy (http://www.TheEventLine.info/forms/safesanctuary.shtml).

PLEASE PRINT, DATE, SIGN AND RETURN A HARD COPY OF THIS FORM TO YOUR AREA DIRECTOR.
KEEP A COPY FOR YOUR RECORDS.