Personal Info

Let us know about yourself! Who are you?

Email *

First Name *

Middle Name

Last Name *

Preferred Name

Suffix

Birth Date*

Phone Number *

Street address *

City *

State *

ZIP Code *

Photo *

We will also be getting ESCA Badges, as they are becoming more widely used for you to gain access to venues/facilities. We will need a photo of you to use for the badge. Just a plain headshot photo will suffice.

Who told you about us (if any)?

Professional Interests

List any areas (up to 5) that fit into these categories for you.

By providing this information, you will allow us to provide one of the following:

Match you to a position that is requested for an event.
Give you opportuntities to gain experience in any given area by booking you into calls that fit and do not require you to be completly on your own.
Match you with any training opportunities if/when they become available.

Positions in which you are proficient *

Positions in which you are not completely proficient *

Positions in which you want training *

Resume *

More Details

Given the nature of our work, we need your thoughts on the following.

Are you willing to travel? *

Yes

Do you have OSHA 30 certification? *

Yes

Are you COVID19 vaccinated? *

Yes

Prefer not to say

Do you have any other certifications or qualifications that you would like to share? If so, please list them here.

Accounting Details

We want to pay you for the work you do! So please provide all the relveant information below.

W-9 Information

View the official W-9 form here and fill out the information below.

Name (as shown on your income tax return) *

Business Name (if different than above)

Address (number, street, and apt. or suite no.) *

City, state, and ZIP code *

List Account number(s) here (optional)

Federal Tax Classification *

Exempt Payee Code (if any)

Exemption from FATCA Reporting Code

Enter your EIN or SSN *

EIN

SSN

Type your full name. *

Date *

Click here to indicate that you accept your typed name as your signature. *

Payment

How would you prefer to receive your paycheck? *

Paper

Direct Deposit