|
Contact
info: |
| *first
name: |
|
| *last
name: |
|
| company: |
|
*physical
street address: |
suite, apt or lot number
provide additional mailing
post office box addresses below
(PO box, city, state & zip) |
| post
office
box
address: |
|
| *physical
address city: |
|
| *physical
address state: |
|
*zip
or
postal code: |
|
| *home
phone: |
|
| fax: |
|
| voice
mail: |
|
| pager: |
|
| cell
phone: |
|
| alternate
phone |
work
relative
business |
| *e-mail
address: |
|
| *transportation |
bus, subway, taxi
car
walk, offered a lift or none |
| *car
availability |
own
rent
borrow
none |
| roadservice |
yes (AAA, Mobil, etc) carried on vehicle
no roadservice |
reliability
of
vehicle |
vehicle
can be trusted to travel 50 miles or more from home?
yes
no |
*employment
status |
full
part time employee
student
retired
under employed
self employed
unemployed |
*current
employment
type |
free lance entertainment or acting
hourly or salaried entertainment or acting
traditional (non-entertaining, non-acting) hourly or salaried
work |
| |
*current
occupation or field of expertise/training |
| |
|
| union
affiliations |
NON union
union member |
| union
member |
SAG
SAG eligible
AFTRA
AEA
AGVA |
*listed
with
other agencies |
exclusive
multi-listed
not listed with other agencies |
| |
Physical
stats |
| *male
or female |
male
female |
| *date
of birth |
|
| *height |
foot
inches |
| *weight |
pounds |
| *eye
color |
|
| *hair
color |
|
| *dwarf
type |
|
| *ethnic
origin |
caucasian
black
hispanic
asian
other
|
| *mobility |
ambulatory
ambulatory w/ limitations (*indicated below)
chair user, electric
chair user, manual
cane, walker, crutches
personal attendant |
| facial
hair |
mustache
beard
none |
| glasses/contacts |
glasses
contacts
none |
| |
*special
needs, physical
requirements or limitations
(walking, standing, dietary, etc.) |
| |
|
| |
Resume
info list info here or attach in postal mail or additional
e-mail |
| |
past
entertainment
credits
and/or acting gigs |
| |
|
| |
special
skills and/or
talents |
| |
|
| |
*real
world resume |
| |
|
|
*
Fields with an asterik need to be completed for form
to be submitted properly. You may want to provide
additional info in remaining fields so that we may respond
and fill your request as quickly and as completely as
possible.
Thank
you!
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