MILLER EVENT MANAGEMENT, INC.

MILLER EVENT MANAGEMENT, INC.
The questions found in this form are being asked to evaluate your ability and chance for success in the position for which you are applying. efforthasbeen made to comply with applicable federal law and laws of our state. It is not our intent to discriminate in employment on Every account of race, color, sex (including pregnancy, child birth or related medical conditions, including breast feeding or medical conditions related to breast feeding), ancestry, religion, (including religious dress or grooming practices), age (over 40 years of age), expression, marital status, military or veteran status or any other status protected by state or federal law.
APPLICANT INFORMATION
Today's Date

Month Day Year
Date
Name

First Name Last Name
Middle Initial
Nickname
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Apartment/Unit #
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date Available

Month Day Year
Date
Guard Card #
Expiration Date

Month Day Year
Date
Referred By:
Have you ever worked for this company before?
Are you willing to work a graveyard shift?
EDUCATION
High School
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Did you Graduate?

YES NO
College
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Degree
Did you Graduate?

YES NO
From
To
PERSONAL INFORMATION
Are you able to perform the essential functions of the position you are applying for with or without reasonable accommodation?

YES No
Name of person to be contacted in case of Emergency:
Phone Number of Emergency Contact
Please enter a valid phone number.
Are you related to anyone in our company?

YES NO
Are you employed now?

YES NO
Where?
Previous Employment: Company Name and Address
Phone
Supervisor
Job Title
Job Responsibilities
From
To
Reason for leaving
May we contact your previous supervisor for a reference?

YES NO
Company Name and Address
Phone Number
Please enter a valid phone number.
Supervisor
Job Title
Job Responsibilities
From:
To:
Reason for leaving
May we contact your previous supervisor for a reference?

YES NO
Military Service: Branch
From:
To:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
Reference 1

First Name Last Name
Relationship
Phone number
Reference 2

First Name Last Name
Relationship
Phone Number
Please enter a valid phone number.
Reference 3

First Name Last Name
Relationship
Phone Number
Please enter a valid phone number.
Signature

Clear
Date

Month Day Year
Date
AND UNERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF INFORMATION REQUESTED ON THIS FORM IS GROUNDS FOR IMMEDIATE DISMISSAL. I AUTHORIZE MILLER EVENT MANGEMENT, INC TO THORUGHLY INVESTIGATE MY REFERENCES AND WORK HISTORY AND FURTHER AUTHORIZE ALL PRIOR EMPLOYERS, EDUCATIONAL INSTITUTIONS OR REFERENCES TO DISCLOSE TO COMPANY ALND ALL INFORMATIONS RELATED TO MY WORK RECORD, SCHOOL OR EDUCATIONAL DEGREES AND ANY OTHER RELEVANT INFORMATION. I HEREBY RELEASE MILLER EVENT MANAGEMENT, INC, FORMER EMPLOYERS AND ALL OTHER PERSONS, CORPORATIONS, PARTNERSHIPS, SOCIATIONS, EDUCATIONAL INSTITUTIONS FROM ANY AND ALL CLAIMS, DEMANDS, OR LIABILITIES ARISING OUT OF OR IN ANY WAY RELATED TO SUCH INVESTIGATION OR DISCLOSUER. I UNDERSTAND THAT WEEKEND WORK, OVERTIME, CHANGES OF SCHEDULE AND LOCATION MY BE REQUIRED DURING MY EMPLOYMENT. FURTHER, I UNDERSTAND THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PREVIOUS NOTICE, WITH OR WITHOUT CAUSE. IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO ALL RULES, REGULATIONS AND POLICIES OF THIS COMPANY. NO MODIFICATION OF THESE STATEMENTS SHALL BE VALID UNLESS WRITTEN AND SIGNED BY THE COMPANY PRESIDENT.
DATE

Month Day Year
Date
SIGNATURE

Clear
I, the undersigned, understand that I am being considered as a potential employee of the company, and hereby certify that: I agree that if I am hired, such hiring will not be for any definite period of time. Even though, if hired, I will be paid my wages on a monthly, semi-monthly, weekly or hourly basis, I understand that this does not mean I am being hired for a definite period of time. I agree that if hired, I will be an employee at-will and I can be terminated at any time, with or without cause, with or without cause, with or without notice. I agree that the at-will nature of the employment relationship cannot be changed except in a written document signed by the company president and myself. I further represent that no representative of the company has made any promises or other statements to me, which imply that I will be employed on anything other than an at-will employment basis.
Signature

Clear
Date

Month Day Year
Date
Should be Empty:

MILLER EVENT MANAGEMENT, INC.

APPLICANT INFORMATION

EDUCATION

PERSONAL INFORMATION