Name

E-Mail

Home Address

Contact Telephone

Position Desired

Web Designer/ Production Artist Web Marketing/ Graphic Designer (Intern)

Pay Expected

Year Hour

Are you legally eligible for employment in the United States? (Proof of U.S. Citizenship or immigration status will be required for employment)

Will you work overtime if needed?

Yes No

Are you currently employed?

Yes No

If you are under 18, and it is required, can you furnish a work permit?

Yes No

What type of work are you looking for?

Part-time Full-time Seasonal Temporary Educational Co-op

Date available to begin work:

mm/dd/yyyy format.

Do you have a valid driver's license?

Yes No

Do you have access to a car?

Yes No

High School

Name and Location of School

Course Study

# of Years Completed

Did You Graduate?

Year Graduated

Degree or Diploma

Bus/Trade/Tech

Name and Location of School

Course Study

# of Years Completed

Did You Graduate?

Year Graduated

Degree or Diploma

College

Name and Location of School

Course Study

# of Years Completed

Did You Graduate?

Year Graduated

Degree or Diploma

Graduate

Name and Location of School

Course Study

# of Years Completed

Did You Graduate?

Year Graduated

Degree or Diploma

Do you have any relevant job experience for the position you are applying for? Example: experience with web design, data entry, graphic design, etc.

Can you perform the essential functions of the position for which you are applying with or without reasonable accommodations?

When completing this section do not disclose information regarding convictions that have been judicially sealed, expunged, eradicated, impounded, or dismissed. Do not disclose information regarding juvenile court convictions or minor traffic violations. A conviction record does not automatically bar your from employment with Imagine It Studios. All of the job-related circumstances surrounding convictions will be considered.

1. In the last 7 years, have you ever been convicted of, pled guilty or no contest to, been imprisoned, or on probation for any felony?

2. In the last 7 years, have you ever been convicted of, pled guilty or no contest to, been imprisoned, or on probation for any misdemeanor?

3. Do you currently have charges pending against you?

4. Are you currently on probation?

5. If you answered yes to any of the above questions, please explain completely. (Answering will not exclude you from consideration.)

DATE ENTERED/ Month Year

DATE DISCHARGED/ Month Year

BRANCH

Please provide an accurate and complete full-time and part-time employment record. Start with your most recent employer.

Previous Experience 1

Company Name

Dates Employed

01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 to 01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Telephone

Address

Pay

starting

Hour Year

finish

Hour Year

Name of Supervisor

May we contact employer?

Yes No Later

Job Title

Work Description

Employment Status

Full Time Part Time

Previous Experience 2

Company Name

Dates Employed

01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 to 01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Telephone

Address

Pay

starting

Hour Year

finish

Hour Year

Name of Supervisor

May we contact employer?

Yes No Later

Job Title

Work Description

Reason for leaving?

Employment Status

Full Time Part Time

Previous Experience 3

Company Name

Dates Employed

01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 to 01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Telephone

Address

Pay

starting

Hour Year

finish

Hour Year

Name of Supervisor

May we contact employer?

Yes No Later

Job Title

Work Description

Reason for leaving?

Employment Status

Full Time Part Time

Previous Experience 4

Company Name

Dates Employed

01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 to 01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Telephone

Address

Pay

starting

Hour Year

finish

Hour Year

Name of Supervisor

May we contact employer?

Yes No Later

Job Title

Work Description

Reason for leaving?

Employment Status

Full Time Part Time

Previous Experience 5

Company Name

Dates Employed

01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 to 01 02 03 04 05 06 07 08 09 10 11 12 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Telephone

Address

Pay

starting

finish

Name of Supervisor

May we contact employer?

Yes No Later

Job Title

Work Description

Reason for leaving?

Employment Status

Full Time Part Time

Have you ever been dismissed or forced to resign from any employment?

Yes No

if yes, please explain.

Reference 1

Name

Address / Phone Number

Years Known

How Acquainted?

Reference 2

Name

Address / Phone Number

Years Known

How Acquainted?

Reference 3

Name

Address / Phone Number

Years Known

How Acquainted?

"I certify that the facts contained and entered in this application are true and complete to the best of my knowledge and understand that, if employed, falsified or misleading statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damages that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative."

Imagine It Studios reserves the right to administer pre-employment and random drug testing on all candidates and employees. Imagine It will keep applications on file for 1 year past the date on the application.

By typing your full name in the field below, constitutes that you agree that you are signing this as a document.