This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. Please answer all questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the interview process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, age, creed, national origin or the presence of disabilities. Steamboat Lightscapes, Inc. is an equal opportunity employer.

Include only individuals familiar with your work ability. Do not include relatives.

List last 4 employers, starting with most recent, please include phone number

Please provide the following information from your current license

Do not disclose your own injuries

Other than parking violations

I certify that I have read and understand the applicant note on page one of this form and that the answers given by me to the foregoing question and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omission or misrepresentations of fact in this application may be grounds for termination of my employment. In consideration of my employment, I agree to conform to the Company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the Company’s option. I also understand and agree that the terms and conditions of my employment may be changed with or without cause, and with or without notice, at any time by the Company.