Media Technology Job Application Form

MEDIA TECHNOLOGY JOB APPLICATION FORM

Applicant Information

Position, Availability & Compensation Expectations

Desired Start Date:

Education & Technical Qualifications

Employment History (Most Recent First)

Portfolio & Work Samples

Project / Sample Title:

References

Background & Authorizations

Have you ever been convicted of a felony that has not been expunged or sealed? Yes No

I authorize the prospective employer to verify the information provided and to obtain references and background information where permitted by law.

Employment Agreement — Conditional Offer & Terms

WHEREAS, Employer Name: (the "Employer") is engaged in media technology, production, distribution and related services; and

WHEREAS, Applicant Name: (the "Applicant") has applied for employment and represents that the information provided in this form is true and complete; and

WHEREAS, the parties may enter into a formal employment agreement reflecting the terms below if the Applicant is selected.

Scope of Work

Describe the primary duties, deliverables and expectations for the role. This description will form the basis of any subsequent employment agreement.

Payment Terms

Base Compensation Amount:

Payment Schedule (select one or describe):

Late Payment Fee (if applicable):

Term and Termination

Proposed Start Date:

Proposed End Date (if fixed-term):

Either party may terminate the employment agreement for convenience upon providing written notice to the other party. Minimum notice period (in days):

Confidentiality

The Applicant acknowledges that, as a condition of employment, the Applicant will have access to proprietary and confidential information concerning the Employer's business, products, processes, trade secrets, projects, client lists and creative works. The Applicant agrees that, during the term of employment and thereafter, the Applicant shall not disclose, use or permit the use of any such confidential information except as necessary to perform job duties and as authorized in writing by the Employer. Upon termination the Applicant will return all confidential materials and will not retain copies in any form.

Governing Law

This conditional employment agreement and any subsequent employment agreement shall be governed by and construed in accordance with the laws of the governing jurisdiction designated by the Employer at the time of offer. The parties agree that disputes shall be resolved in the courts of that jurisdiction unless otherwise agreed in writing.

Entire Agreement

This document, together with any executed offer letter and subsequent employment agreement signed by the parties, constitutes the entire understanding between the parties with respect to the subject matter herein, and supersedes all prior or contemporaneous oral or written agreements, representations, warranties and understandings. Any modification must be in writing and signed by both parties.

Applicant Certification

I certify that the information provided in this application is true, complete and correct to the best of my knowledge. I understand that any false statements, omissions, or misrepresentations may result in refusal of employment or, if employed, termination. I acknowledge that submission of this form does not constitute an employment contract.

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