HOLLYWOOD THEATRE

APPLICATION FOR EMPLOYMENT

(PRE-EMPLOYMENT QUESTIONNAIRE)

(AN EQUAL OPPORTUNITY EMPLOYER)

The company does not discriminate in hiring or employment on the basis of race, color, religion, national origin, sex, marital status, ancestry, age (as defined by applicable law), legally
recognized handicap, or veteran status. No question on this application is intended to secure information to be used for any discriminatory purpose.

PERSONAL INFORMATION

DATE:_____________________________

NAME: (LAST)_________________________________(M.I.)___________(FIRST)__________________________________
PRESENT ADDRESS:
(STREET)_____________________________________(CITY)________________________(STATE)_____(ZIP)____________

PERMANENT ADDRESS:
(STREET)_____________________________________(CITY)________________________(STATE)_____(ZIP)____________

HOME PHONE:__________________________________OTHER :______________________________________

ARE YOU 18 YEARS OF AGE OR OLDER?
( )NO
( )YES

EMPLOYMENT DESIRED
POSITION DESIRED:_______________________START DATE:______________DESIRED PAY: $______P/H
ARE YOU EMPLOYED NOW? ( )NO ( )YES
IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? ( )NO ( )YES
HAVE YOU EVER APPLIED TO THIS COMPANY BEFORE? ( )NO ( )YES
IF SO, WHERE?___________________________ IF SO, WHEN?______________________________
REFERRED BY:_______________________________________________________________________________

EDUCATION
(NAME OF SCHOOL)

(LOCATION OF SCHOOL)

HIGH SCHOOL_________________________________________/_____________________________________
COURSES STUDIED_________________________________YEARS COMPLETED_________GRADUATE? NO( ) YES( )
STILL ENROLLED ( )

COLLEGE____________________________________________/_______________________________________
COURSES STUDIED_________________________________YEARS COMPLETED_________GRADUATE? NO( ) YES( )
STILL ENROLLED ( )

OTHER______________________________________________/_________________________________________
COURSES STUDIED_________________________________YEARS COMPLETED_________GRADUATE? NO( ) YES( )
STILL ENROLLED ( )

EXPERIENCE

PLEASE GIVE ACCURATE, COMPLETE, FULL-TIME AND PART-TIME EMPLOYMENT RECORD

COMPANY NAME____________________________________CITY/STATE______________________________
TELEPHONE NUMBER_______________________________SUPERVISOR_____________________________
DATE HIRED_____________DATE TERMINATED_____________FINAL SALARY $_____________________
DUTIES_______________________________________________________________________________________
REASON FOR LEAVING________________________________________________________________________
COMPANY NAME____________________________________CITY/STATE______________________________
TELEPHONE NUMBER_______________________________SUPERVISOR_____________________________
DATE HIRED_____________DATE TERMINATED_____________FINAL SALARY $_____________________
DUTIES_______________________________________________________________________________________
REASON FOR LEAVING________________________________________________________________________
COMPANY NAME____________________________________CITY/STATE______________________________
TELEPHONE NUMBER_______________________________SUPERVISOR_____________________________
DATE HIRED_____________DATE TERMINATED_____________FINAL SALARY $_____________________
DUTIES_______________________________________________________________________________________
REASON FOR LEAVING________________________________________________________________________
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REFERENCES
NAME_____________________________________OCCUPATON______________________________________
ADDRESS__________________________________PHONE____________________________________________
NAME______________________________________OCCUPATON_____________________________________
ADDRESS___________________________________PHONE___________________________________________
NAME______________________________________OCCUPATON_____________________________________
ADDRESS___________________________________PHONE___________________________________________

TELL US ABOUT YOURSELF

Do you have any special qualities you think we should know about?
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________

AVAILABILITY
Due to the nature of the film industry, we do not have set opening or closing times. As such, employees are expected to
keep flexible schedules and be available for work everyday, including holidays. We are open every evening of the year
and afternoons on weekends and whenever school districts are closed. We are, sometimes, able to accommodate people
with limited availability (School, Other Employment) but availability is the number one factor in hiring.
Do you have any times you are not available? ____________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

I certify that the information included on this application form is accurate and complete. I authorize the investigation
of all statements contained in this application. I understand that misrepresentation of facts called for is cause for
dismissal. Further, I understand and agree that if I am offered employment with the company, my employment is for
no definite period and that either I or the company will have the right to terminate the employment relationship at any
time, with or without cause, and with or without notice.
DATE_____________________SIGNATURE OF APPLICANT___________________________________

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