How did you hear about this opportunity at ACM Records?

Have you ever been employed by a recording/publishing company before?

Yes No

If Yes, please give dates of employment, position, and reason(s) for leaving:

Position Applying For:

PERSONAL

Full name

E-mail address

*REQUIRED

Street Address

City

State

Zip

Evening Phone

Day Phone

If you lived at the above address for less than three (3) consecutive years, please list previous addresses below:

Street Address

City

State

Zip

Street Address

City

State

Zip

Are you at least 18 years old

Yes No

Have you had any changes in name or used an assumed name?

Yes No

If Yes, please identify name(s):

Do you have any friends or relatives working with ACM Records?

Yes No

If Yes, Name:

Where do they work?

What position do they hold?

AUTHORIZATION TO WORK

Are you a citizen or legally authorized to work in the United State?

Yes No

WORK EXPERIENCE

List the names of your present and previous employers in chronological order. List your current or most recent position first. Be sure to account for all periods of time including military service or any period of unemployment. If self-eomplyed, give firm name and supply business references.

Present or Last Employer

Address

City

State

Zip

Phone

Employed From (mo/yr)

Employed To (mo/yr)

Pay Starting $

Ending Pay $

Your Title or Position

Supervisor's Name/Title

Describe Duties:

Exact Reason for Leaving (Please be specific)

Present or Last Employer #2

Address

City

State

Zip

Phone

Employed From (mo/yr)

Employed To (mo/yr)

Pay Starting $

Ending Pay $

Your Title or Position

Supervisor's Name/Title

Describe Duties:

Exact Reason for Leaving (Please be specific)

Present or Last Employer #3

Address

City

State

Zip

Phone

Employed From (mo/yr)

Employed To (mo/yr)

Pay Starting $

Ending Pay $

Your Title or Position

Supervisor's Name/Title

Describe Duties:

Exact Reason for Leaving (Please be specific)

Present or Last Employer #4

Address

City

State

Zip

Phone

Employed From (mo/yr)

Employed To (mo/yr)

Pay Starting $

Ending Pay $

Your Title or Position

Supervisor's Name/Title

Describe Duties:

Exact Reason for Leaving (Please be specific)

Have you ever been terminated or asked to resign from any job?

Yes No

If Yes, please explain circumstances and list which job:

May we contact your current employer?

Yes No

Please explain any gaps in your employment history:

Do you have adequate transportation to and from work?

Yes No

Do you have the ability to perform the duties of the position(s) for which you are applying with or without reasonable accommodation?

Yes No

WORK AVAILABILITY

Are you available for full time work?

Yes No

Will you work overtime if asked?

Yes No

When will you be available to begin work?

Check the time during each day you would be available to work (N/A= not available to work that day):

Monday........ AM  PM  NA     Tuesday   AM  PM  NA
Wednesday  AM  PM  NA     Thursday  AM  PM  NA
Friday........... AM  PM  NA     Saturday  AM  PM  NA
Sunday......... AM  PM  NA

ATTENDANCE

Except for vacations and holidays, how many work days have you been absent during this calendar year?

0-5 Days 5-10 Days 10-15 Days 15-20 Days 21+ Days

During the prior calendar year?

0-5 Days 5-10 Days 10-15 Days 15-20 Days 21+ Days

PREVIOUS EXPERIENCE

Please indicate any experience you have which you feel is relevant to the position you are applying for:

EDUCATION

High School

Years Completed

9 10 11 12

Diploma/Degree

Yes No

Describe Course of Study or Major

Describe any Specialized Training, Experience, Skill and Extra-Curricular Activities

College/University

Years Completed

1 2 3 4

Diploma/Degree

Yes No

Describe Course of Study or Major

Describe any Specialized Training, Experience, Skill and Extra-Curricular Activities

Graduate/Professional

Years Completed

1 2 3 4

Diploma/Degree

Yes No

Describe Course of Study or Major

Describe any Specialized Training, Experience, Skill and Extra-Curricular Activities

Trade or Correspondence

Diploma/Degree

Yes No

Describe Course of Study or Major

Describe any Specialized Training, Experience, Skill and Extra-Curricular Activities

Other

Diploma/Degree

Yes No

Describe Course of Study or Major

Describe any Specialized Training, Experience, Skill and Extra-Curricular Activities

OTHER SPECIAL TRAINING, SKILLS, EDUCATION OR CERTIFICATES

List only those that are job related; exclude those which could indicate race, creed, color, sex, age, religion, national origin or disability.

MILITARY SERVICE

Have you ever served in the United State military

Yes No

If Yes, in which branch did you serve?

Please identify the dates of service:
Do not answer the question relating to dates of service if you are applying for employment in the state of California.

Please describe any work experience or skills gained in the military that are relevant in the job being applied for:

PERSONAL REFERENCES

Please list persons who know you well - not previous employers or relatives.

Name

Occupation

Phone

Address (Street, City & State)

Number of Years Known

Name

Occupation

Phone

Address (Street, City & State)

Number of Years Known

Name

Occupation

Phone

Address (Street, City & State)

Number of Years Known

Please complete for any positions in which driving may be required:

Do you have a current driver's license?

Yes No

State:

Yes No

If Yes, please explain the circumstances:

Please list all moving violations in the past five (5) years:

Offense #1

Date

location

Offense #2

Date

location

Offense #3

Date

Location

Offense #4

Date

Location

YOU WILL BE REQUIRED TO PROVIDE PROOF OF INSURANCE IF ACCEPTING CERTAIN POSITIONS WHICH REQUIRE DRIVING ON BEHALF OF ACM RECORDS.