Employee Multimedia Journalist Form

EMPLOYEE MULTIMEDIA JOURNALIST FORM

Personal Information

Position Information

Position Title:   Department:

Reporting Manager:   Proposed Start Date:

Employment History

Most Recent Employer

Previous Employer

Education

Professional References

Reference 1

Reference 2

Reference 3

Skills, Equipment & Work Samples

Legal Disclosures & Authorizations

At-Will Employment: I understand and acknowledge that, if employed, my employment will be at-will and may be terminated by me or the employer at any time, with or without cause or notice, unless a written agreement signed by an authorized representative of the employer states otherwise.

Equal Opportunity: The employer is an equal opportunity employer. Employment decisions are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by applicable law.

Background, Reference & Copyright Authorization

Authorization to Investigate: I authorize the employer and its agents to conduct investigations of my background, including but not limited to criminal history, employment verification, education verification, credit check where job-related and permitted by law, and professional references. I release from liability all persons and organizations that provide or receive such information and agree that the employer may rely on such information in making employment decisions.

Work‑for‑Hire and Assignment: I understand that any recordings, photographs, written copy, video, audio, or other creative works produced by me in the course of my employment are presumed to be works made for hire and the exclusive property of the employer. To the extent any such works are not works made for hire, I hereby irrevocably assign and transfer to the employer all right, title, and interest, including copyrights, in such works, without additional compensation.

Media Release & Confidentiality

Likeness Release: I consent to the use by the employer of my name, likeness, voice, and biographical material in any media now known or later developed for legitimate business purposes, including publicity and promotion, without further compensation, unless otherwise prohibited by law.

Confidentiality: I acknowledge that I may have access to confidential information and agree to hold and treat as confidential all proprietary information of the employer and its sources obtained in the course of employment. This obligation continues after termination of employment to the extent permitted by law.

Applicant Certification & Acknowledgements

I certify that all information provided on this form is true and complete to the best of my knowledge. I understand that falsification, misrepresentation, or omission of facts on this form or in any supporting documents is grounds for refusal to hire or for termination of employment.

I authorize the employer to contact the references and previous employers listed above. I understand that employment is contingent upon satisfactory reference checks, background checks, and any required clearances.

Additional Information

Acknowledgement of Truthfulness

By signing below I affirm that I have read and understand the statements and authorizations contained in this form and that I provide my voluntary consent to the uses and disclosures described herein.

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