Glimmerglass Festival: Personal Information Form
This information is shared only with the Safety Coordinator and necessary managers.
Last Name *
Your answer
First Name *
Your answer
Name as it should appear in Glimmerglass program and on issued I.D. badge: *
Your answer
Date of Birth *
MM
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DD
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YYYY
Email Address: *
Your answer
Please Confirm Your Email Address: *
Your answer
Would you like to be added to a company e-newsletter system to be used ONLY for communication during the 2019 Festival? *
This in an internal communication system for the 2019 Festival. Your information will be deleted after the 2019 Festival.
Cell Phone Number: *
Format: 555-555-5555
Your answer
Cell Phone Carrier: *
Other than Verizon, many cell phone carriers provide poor or no service in the Cooperstown area.
Your answer
Current Address: Street or P.O. Box *
Ex: PO Box or Street
Your answer
Current Address: Apartment Number or C/O (Optional)
Your answer
Current Address: City, State (Abbrev.), Zip *
Your answer
Name of your current employer or school you are attending: *
If unemployed, list "none"
Your answer
Permanent address: Street or P.O. Box *
This is where end-of-year financial forms will be sent.
Your answer
Permanent address: Apartment Number or C/O (Optional)
This is where end-of-year financial forms will be sent.
Your answer
Permanent address: City, State (Abbrev.), Zip *
This is where end-of-year financial forms will be sent.
Your answer
Agent name and contact information, if applicable:
Your answer
Work visa number, if applicable:
Your answer
Date 2019 Glimmerglass Contract Begins: *
(Workweek Monday-Sunday)
MM
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DD
/
YYYY
Date 2019 Glimmerglass Contract Ends: *
Workweek Monday-Sunday)
MM
/
DD
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YYYY
2019 Glimmerglass Title *
Is this the first time you have been employed by Glimmerglass? *
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