Stunt & Actor Application

Stunt & Actor Application
General Information
First Name
Last Name
Date of Birth
Age
Marital Status
Place of Birth
Dates you are available
To
Are you currently under contract?

Yes No
If "yes", until when?
Are you willing to relocate?

Yes No
Have you ever worked around pyrotechnics?

Yes No
Have you ever worked around flame units?

Yes No
Contact Information
Home Phone
Cell Phone
Email Address
Web Site
Present Address
Street
City
State
Zip
Permanent Address
Street
City
State
Zip
Emergency Contact
Name
Phone
Street
City
State
Zip
Physical Characteristics
Height
Weight
Hair Color
Eye Color
Shoe size
Gender
Male Participants
Chest size
Waist size
Inseam
Shirt size
Female Participants
Bust size
Waist size
Hip Size
Shirt size
Skills & Experience
*Please describe your skills and experience in the following areas
Acting
Movement
Sight-reading
High falls
Stage fighting
Tumbling
Swimming
Motorcycles
Boats/Watercraft
Other Experience
Additional Comments on Skills
Detail any listed skill or tell us about other skills
Show Experience - Show 1
Name
Show Director
From Date
To Date
Phone Number
Duties, skills, and positions performed in
Show Experience - Show 2
Name
Show Director
From Date
To Date
Phone Number
Duties, skills, and positions performed in
Physical Record
Have you had an accident/injury in the past 3 years?

Yes No
If "yes", please explain
Have you had a physical condition that required treatment or surgery within the past 3 years?

Yes No
If "yes", please explain
Do you have a current injury that will affect your acting abilities?

Yes No
If "yes", please explain
Education
High School
Date Graduated
College
Date Graduated
References
Name
Address
Phone Number
Name
Address
Phone Number
Additional Information
During the past 7 years, have you been convicted of a misdemeanor?

Yes No
During the past 7 years, have you been convicted of a felony?

Yes No
If "yes", please explain (conviction of a crime is not an automatic bar to employment. All circumstances are considered.)
How did you learn about us?
Acknowledgement
1. I hereby represent that each answer to a question and all other information furnished on this application is true and correct to the best of my knowledge.

2. I understand that any false statements made on this application shall be considered sufficient cause for rejection of this application and/or termination of employment.

3. Upon acceptance of employment, I agree to provide documents that establish my identity and employment eligibility.

4. I hereby authorize my former employers to give any information regarding my employment with them and in addition to furnish any other information that they might have concerning me.

* I certify that I am at least 18 years of age and that I have read, understand and agree to each statement written above. Do you accept the terms listed in the above acknowledgement?
Do you accept the terms listed in the above acknolwedgement?

Yes No
Today's Date
Should be Empty:

Stunt & Actor Application

General Information

Contact Information

Present Address

Permanent Address

Emergency Contact

Physical Characteristics

Male Participants

Female Participants

Skills & Experience

Additional Comments on Skills

Show Experience - Show 1

Show Experience - Show 2

Physical Record

Education

References

Additional Information

Acknowledgement