Questionnaire

 

 

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If you're ready to get on the road to a brighter, more rewarding future, start by filling out and printing the questionnaire


Tell us how to get in touch with you:

Name
Address Line 1
Address Line 2
City
State
Zip
E-mail
Home Phone
Work Phone   Ext: 
Fax

Enter Current Information

Current Job: 

Station/Network: 

Current salary:    

Other income:    

Under contract? Yes No   If yes, contract expiration    

If under contract, list
any clauses / special details? 

Currently represented by another agency? Yes No  
If yes, when does it expire?     


Desired Position

Desired Job:  

Desired Salary:    

Geographic/Market:  

List 3 career goals:  

Please contact me as soon as possible regarding this matter.


Mail questionnaire and audition tape (VHS only) to:
Media Alliance®
P.O. Box 3474
Ft. Myers, FL 33918

   

 

 

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