ALL STARS PROJECT, INC. I.

PERSONAL INFORMATION
Name Last Address Number City Tel. No. ___________________________________ Area Code Number $____________________ ____________________ Street State Social Security No. Date Available Referred to us by Apt. Number Zip Code First Middle

Min. Salary Requirement Position Desired

All Stars Project, Inc. is an Equal Opportunity Employer. Discrimination in employment is prohibited on the basis of age, sex race, color, religion, disability, national origin, marital status, sexual orientation, gender identity or expression, citizenship status, genetic predisposition or carrier status, military status and any other classification protected under federal, state or city law.

II. EMPLOYMENT RECORD

Give a complete consecutive statement of your employment history. All time must be accounted for since leaving school or college, including time unemployed, if any. Company Name and Complete Address Name of Supervisor Title or Work Performed Company Name and Complete Address Name of Supervisor Title or Work Performed Company Name and Complete Address Name of Supervisor Title or Work Performed Base Rate of Pay From Title Reason for Leaving Base Rate of Pay* From Title Reason for Leaving Base Rate of Pay* From Title Reason for Leaving Tel. No. Dates Employed Month/Yr To Tel. No. Dates Employed Month/Yr To Tel. No. Dates Employed Month/Yr To

Base pay only, do not include overtime, bonus, profit sharing, etc.

Company Name and Complete Address Name of Supervisor Title or Work Performed

Base Rate of Pay* From Title Reason for Leaving Tel. No.

Dates Employed Month/Yr To

* Base pay only, do not include overtime, bonus, profit sharing, etc.

III. EDUCATION AND TRAINING

High School City/State Type of Diploma or Degree Received

College/University

City/State

Type of Diploma or Degree Received

Graduate School

City/State

Type of Diploma or Degree Received

Other School

City/State

Type of Diploma or Degree Received

Are there any other experiences, skills or qualifications which you feel would especially qualify you for work with All Stars Project, Inc? _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________

IV. OTHER
A. Military Service Record Were you in the U.S. Armed Forces? Yes___ No___ B. Criminal Record Have you ever been convicted of a crime or felony? Yes___ No___ If yes, please give the nature of the offense, the date, the court, and the sentence imposed. _________________________________________________________________________________________________ _________________________________________________________________________________________________ (Conviction of a crime or felony will not necessarily prevent your employment)

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C. Have you ever been employed under another name? Yes____ No ____ If so, please give any other name you have used: ____________________________________________________________ D. Are you eligible to work in the U.S.? Yes____ No ____ If hired, you will be required to provide proof of authorization to work in the United States prior to beginning employment.

In making this application for employment I authorize you to investigate my employment history, including verification of salary information and reason for termination. I declare that the information contained in this application for employment and any attached information is true and complete. I understand that any false statement or the omission of relevant information (including any contained on my resume if I have provided one) may disqualify me from employment or cause my dismissal. I authorize the educational establishments, employers and references I have referenced in this application to release to All Stars Project, Inc. any information concerning my educational record, my employment or any other information relevant to my employment. I hereby release all such persons and entities from any liability arising out of the release of such information. I further understand that this investigation may include contact with my present employer and all of my former employers. I further understand that this application is not, and is not intended to be, a contract of employment nor does this application obligate All Stars Project, Inc. to employ me.

Signature of Applicant

Date

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Please list three professional references. Include name, phone number, email address and affiliate to you.

1.

2.

3.

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