Employment Application Form

Employment History

Start with your current or most recent employer and work backwards. NON-VIDEO RELATED
Current or Most Recent Employer:*
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
Hours worked per Week Reason for Leaving
May we Contact this Employer?*
If currently employed and you do not wish for us to contact your employer, please set forth the reasons why:
Next Recent Employer:
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
Hours worked per Week Reason for Leaving
May we Contact this Employer?
Video Related Employment or Contract History

Start with your current or most recent employer and work backwards. VIDEO RELATED
Video-Related Employer
Name of Employer
Address
City, State, Zip
Last Position You Held:
Immediate Supervisor(s)
Phone Number(s)
Dates of EmploymentMost Recent Salary or Hourly Rate
Job Title and Responsibilities
Hours worked per Week Reason for Leaving
May we Contact this Employer?
Education History
Please list your education including city and state.
High School Attended*
Year of Graduation or GED*
College Attended
Year of Graduation
Major
References

Please list two references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship*
Years Known:*
Reference 2
Name:*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship*
Years Known:*

1. Can you provide proof of eligibility to become employed in the United States?*
If no on #1, are you able to provide such proof which will be required upon contracting with MovingImagesNW?
2. If you are under the age of 18, can you provide required proof of your eligibility to work?*
3. Have you ever filed an application with us before?*
If yes, set forth dates of your application

MonthDayYear
4. Are you currently employed?*
5. Do you have a current valid drivers license or other form of ID?*
6. Are you able and willing to travel for this job?*
How far are you willing to travel? (Distance/cities)
7. Do you have adequate transportation to meet the travel requirements of the job?*
8. Are you aware of any reason that may restrict your ability to perform the essential functions of the job for which you are making application?*
If yes, please explain and describe what accommodations might be necessary:
9. Have you ever been terminated or forced to resign from your employment with any employer?*
If yes, please explain:
10. Have you ever been convicted of a crime including any driving and/or alcohol related offenses?*
If yes, please explain:

What is your understanding of the product that MovingImagesNW will be asking you to produce?*
What is your understanding of the clientele that MovingImagesNW serves?*
How do you see yourself fitting into the mission of MovingImagesNW?*
MOVINGIMAGESNW MISSION STATEMENT: To provide a service through video and photography in creating personal DVDs for promotion and/or memory keepsakes to be used by individuals, families, and organizations. Our specialty is equine-related events and activities, working in the outdoor or natural environment.

Disclaimer & Signature
By Submitting this application I understand that I, as an Independent Contractor, will be providing services for MovingImagesNW (MINW) as a filmmaker (including, without limiatation, services such as videotaping, editing, producing, sales, etc.) to create content to be owned and used by MINW in providing personal DVDs and memories to its client(s) and for such other use and publication as MINW may elect in its sole discretion.

I understand that I will not be an employee of MINW and will be solely responsible for payment of my own taxes, Social Security, and expenses, and will not be entitled to receive any benefits from MINW. MINW will issue Independent Contractor tax forms as required by law.

I further understand and agree that this application is not a contract of employment. I understand and agree that MINW adheres to a policy of employment at will which means that either I, or MINW, may terminate my contract at any time, or for any reason, consistent with application of state and federal law. I understand that to be an independent contractor, I must be lawfully authorized to work in the United States and must show MINW documents to prove this.

I certify under penalty of perjury that all of the information provided in the entire application process including any information provided in addition to this application including, but not limited to, information provided in resumes or interviews is true and correct. I understand that if there is any falsification or omission, this may lead to MINW’s refusal to contract with me or to an immediate termination of an existing contract.
You must check that you understand this disclaimer and digitally sign your name in order to proceed with the application process*

I understandOther
Please prove that you're human and enter in the message below!*
Depending on the size of your sample upload (if applicable), submitting your application may take a few minutes. Please be patient and do not click "Back" or "Reload" on your browser. You will be redirected when the application has been submitted.
Should be Empty:

	Sun	Mon	Tue	Wed	Thur	Fri	Sat
Morning (7am-noon)
Afternoon (noon-5pm)
Evening (5pm-8pm)

	Knowledgeable	Some Knowledge	Little Knowledge	No Knowledge	Willing to Learn	Not Applicable
Camera Operations
Tripod Setup/Usage
Camera Setup
Taping Live Action
Horse Competitions
Editing Software
Adobe CS5
Photoshop

Freelance/Independent Contractor Application

By completing this application, you understand and accept that you are applying for a position as a freelance/independent contractor for MovingImagesNW.

Relatives or Friends Currently or Formerly on our Freelance Roster

Employment History

Video Related Employment or Contract History

Education History

References

Reference 1

Reference 2

Position Desired & Availability

Video & Editing Expertise

Disclaimer & Signature