Name:

   Address:

   City:

   St:

   Zip:

Phone:

Cell Phone:

Work Phone (optional):

E-Mail:

At what times are you available to work with IATSE Local 470? (Weekends, always, certain days, times, etc.)

Do you have your own transportation and are you willing to travel out of a 50 mile radius to work?

Using the numbers 1-5 (1 being excellent and 5 being limited) fill out the skill level chart below. If you have no experience in a particular department, leave the space blank. Please be honest with your evaluation.

SOUND

FLY

RIG

WARD

PROPS

CARP

ELEC

L-BOARD

FORK

SEW

HAIR

SPOT

H-ELEC

VIDEO

Additional comments or things that you think we should know about you.

Signature:______________________________________________Date:_____________

Please mail to:

or

e-mail to: iatse470@gmail.com