Independent Contractor Update

First Name *

Middle Name

Last Name *

Company Name:

Email Address *

Website

Mailing Address *

Apartment Number / Suite Number

City *

State *

Zip Code *

Mobile Phone *

Home Phone

Are you incorporated ? *

Yes

No

Tax ID Number

State

Do you have Workmens Comp insurance?

Yes

No

Upload Workmans Comp. Info

Are you interested in shop work at a shop rate ? *

Yes

No

What is your hourly shop rate?

What is your normal day rate for Production (10hrs worked which includes 2 @ 15 min paid breaks + 1hr unpaid walk away meal break)?

What is your normal day rate for Systems Integration and Repairs (8hrs worked which includes 2 @ 15 min paid breaks + 1hr unpaid walk away meal break)?

What is your normal half-day rate for Production (5hrs which includes 1 @ 15 mins break)

What is your normal half-day rate for Systems Integration and Repairs (4hrs which includes 1 @ 15 mins break)

If we have work available that can’t afford your normal rate, would you like us to keep you in mind or pass you up? *

Keep In Mind

Pass Me UP

Are you interested in hourly jobsite work at less than a day rate? *

Yes

No

Are you able to ascend/descend ladders/stairs, and to position one's self in low level positions, this role may require the ability to move/transport objects up to 50 pounds. The role requires the ability to ascend to rooftops and move in tight spaces to perform and complete inspections with a variety of manual and power tools. *

Yes

No

What Positions Do You Qualify For (check all that apply) *

On a scale of 1-5, 1 being no experience and 5 being large scale events please rate yourself as a:

	1	2	3	4	5
Electrician	1	2	3	4	5
Crew Leader	1	2	3	4	5
Board Operator	1	2	3	4	5
Moving Light Tech	1	2	3	4	5
LED Tech	1	2	3	4	5
Up Rigger	1	2	3	4	5
Down Rigger	1	2	3	4	5
Carpenter	1	2	3	4	5
Heavy Machinery Operator (boom lift, Front End Loader, etc.)	1	2	3	4	5

Do you have a CDL? *

Yes

No

What State?

What Class

Any Driving Infractions?

Do you have any certifications? (check all that apply)

Can you draw with Vectorworks? *

Yes

No

On a scale of 1-5 rate your drawing skills

	1	2	3	4	5
Vectorworks	1	2	3	4	5

Can you draw with Autocadd? *

Yes

No

On a scale of 1-5 rate your drawing skills

	1	2	3	4	5
AutoCadd Lite	1	2	3	4	5
AutoCadd Full	1	2	3	4	5

Do you know Lightwright? *

Yes

No

Do you know of any co-workers that might not be in our database that should be ? *

Yes

No

First Name

Last Name

Email Address

Mobile Phone

Audio Designer	Audio Lead A1	Audio Technician A2
Audio Technician A3	Audio Mix Engineer	Audio FOH Engineer
Lighting Designer	Lighting Programmer	Lighting Lead L1
Lighting Technician L2	Lighting Technician L3	Rigging Lead
Rigging Up	Rigging Down	Rigging Arena Certified
Video Programmer	Video Design	Video Lead V1
Video Technician V2	Video Technician V3	Video Camera Operator
Projection	Project Manager	ME Advance
Technical Director	Carpenter	Stage Manager
Architectural System Repair	On Site Service Repair	Electronics Repair
Moving Light Repair	AV integrator

ETCP - Arena Rigger	ETCP - Theatre Rigger	ETCP - Entertainment Electrician
ETCP - Portable Power Distribution Technician	Osha 10	Osha 30
CM Motor Mechanic Technician	CM Chain hoist Repair Technician	CMP
Fork Lift	Articulating Boom Lift