APPLICATION FOR EMPLOYMENT
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1 APPLICATION FOR EMPLOYMENT Dallas Summer Musicals/DSM Management Group is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, gender, national origin, religion, disability, genetic information, or any other category protected by federal, state, or local law. Each inquiry on this application must be fully answered or completed to be considered for employment. PERSONAL DATA Last Name First Name Middle Name Other names by which you have been known Street and Number City, State, ZIP Street and Number Present Previous How long have you lived there? Years Months How long did you live there? Years Months City, State, Zip Phone Number(s) Home: Cell: Alternate: Are you 16 years of age or older? Yes No Have you ever applied to or worked for this company before? Where? When? Referred by (how did you learn of this position)? Date you can start? Wage Desired: Please indicate below the type of employment for which you are applying: Regular Full-time Regular Part-time Temporary Part-time Please indicate below s or Departments you have an employment interest: Music Hall Usher Box Office Sales Associate Development Marketing Customer Relations/Gift Shop Accounting Maintenance Other Ver. 09/01/2010 Page 1 of 5
2 PREVIOUS EMPLOYMENT INSTRUCTIONS: Please list the names of your present and previous employers in reverse chronological order with present or most recent employer listed first. Include part-time and seasonal employment. If self-employed, give name of business and supply business references. Please DO NOT ANSWER SEE RESUME ; fill out this form completely. If you have additional employment that is relevant to the position for which you are applying, you may attach a resume and/or additional page(s). Employer 1: Dates Employed Work Performed Employer 2: Dates Employed Work Performed Employer 3: Dates Employed Work Performed Employer 4: Dates Employed Work Performed Employer 5: Dates Employed Work Performed Ver. 09/01/2010 Page 2 of 5
3 BACKGROUND INFORMATION Please answer all questions below. 1. Please explain fully any gaps in your employment history. Be sure to account for all periods of time, including military service and any period of unemployment. 2. If hired, can you provide proof that you are legally entitled to work in the U.S.? If not, what steps must be taken for you to begin employment lawfully? 3. Have you ever been terminated or asked to resign from any job? If yes, please explain circumstances: 4. Do you have any friends or relatives working here or at any of our other locations? If yes, Name(s) and Relationship: 5. In connection to a criminal offense (felony or misdemeanor other than minor moving violations), have you ever been convicted, pled guilty or no contest, served probation, had adjudication deferred, or participated in a pre-trial diversion or other program to avoid prosecution? (NOTE: Answering yes to these questions does not constitute an automatic bar to employment.) If you answered yes to any of the preceding questions, please provide dates, offense information, court location and disposition information: 6. Do you have any commitments to any other employer, relationships or arrangements that may affect your employment with us or could cause a possible conflict of interest? If yes, explain: 7. Do you have reliable transportation to/from work daily? 8. List up to three (3) Professional References who are familiar with your work history, skills and abilities, and can provide insight regarding your character (Please list only Professional References: DO NOT list friends & relatives): Reference s Name Your relationship to this person Employer Daytime Phone Number Alternate Phone Number Ver. 09/01/2010 Page 3 of 5
4 EDUCATION School Name City, State Years Completed High School Did you graduate? Describe Course of Study or Major Specialized Experience, Training, Skills, and Extra Curricular Activities College/University Graduate/Professional Trade/Business School List any professional designations, certifications, licenses, or courses that may be applicable to the position for which you are applying: OTHER INFORMATION Please describe any other skills, experience, honors, awards or information that you have which would be relevant to the job for which you are applying: Ver. 09/01/2010 Page 4 of 5
5 I authorize former and present employers, work and personal references, and any other individuals to give Dallas Summer Musicals/DSM Management Group or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to Dallas Summer Musicals/DSM Management Group. I also authorize Dallas Summer Musicals/DSM Management Group to provide truthful information concerning my employment with it to future employers and I agree to hold Dallas Summer Musicals/DSM Management Group harmless for providing such information. I understand that Dallas Summer Musicals/DSM Management Group reserves the right, to the extent permitted by law, to require drug or alcohol screening tests of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to Dallas Summer Musicals/DSM Management Group or its designee. I release Dallas Summer Musicals/DSM Management Group and its designee from any and all liability and damages that may result or arise from any drug test or the provision of information in connection with such a test. I understand that this employment application and any other Company documents are not promises of employment. Should I be employed, I understand that my employment will be at-will. I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice, and that the Company has a similar right. I understand that no manager, representative, or agent 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 foregoing, except that the President and Managing Director of Dallas Summer Musicals may do so in writing. The information given by me on this application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the Company s judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired. I CERTIFY THAT I HAVE RECEIVED A SEPARATE WRITTEN NOTIFICATION THAT THE COMPANY MAY OBTAIN A CONSUMER REPORT ON ME FOR USE IN CONNECTION WITH MY APPLICATION AND, IF I AM HIRED, MY EMPLOYMENT WITH THE COMPANY. I AUTHORIZE THE COMPANY TO OBTAIN THIS REPORT. THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR ONE HUNDRED EIGHTY (180) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY. DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THIS STATEMENT. Applicant s Signature Date Submit Completed Application To: Human Resources Dallas Summer Musicals/DSM Management Group P.O. Box Dallas, TX Fax: (214) Ver. 09/01/2010 Page 5 of 5
6 We are gathering the following information for recordkeeping in compliance with federal regulations. Information provided will be kept confidential and will not be used in hiring decisions. This information sheet will be separated from the application upon submission. Completion or non-completion of this form will not influence any hiring decision. The information on this form will be used only in accordance with applicable laws and regulations. Completion of this form is voluntary. 1. What is your name? 2. What position(s) are you applying for? 3. Gender Male Female I do not wish to disclose this information 4. Are you Hispanic or Latino? Yes No I do not wish to disclose this information 5. If you answered No to question four, please select from one or more of the following categories: White Not Hispanic or Latino Black or African American Not Hispanic or Latino Asian Not Hispanic or Latino Native Hawaiian or Other Pacific Islander Not Hispanic or Latino American Indian or Alaskan Native Not Hispanic or Latino Two or More Races Not Hispanic or Latino I do not wish to disclose this information
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