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JobLikeMe Application Form

Last name *:			First name *:
Date of Birth *:	MM / DD / YYYY
e-mail address *:			Telephone *:
Home address 1 *:
Home address 2:
City *:		State *:	Zip Code *:
University/College *:			Degree Plan *:

General Terms & Conditions:	General Terms and Conditions and Legal Disclaimers General By entering, you agree to be bound by these general terms and conditions and legal disclaimers. The prize is not transferable. No substitution of a prize for cash or for other goods and services is permitted. The winner must complete the attached Commercial Video Release and the attached Affidavit of Eligibility/ Liability Release and Publicity Release (except where and as prohibited). All entries become the property of Gemalto and will not be acknowledged or returned. Gemalto is not liable for lost, stolen, misdirected, mutilated, incomplete, illegible, or late entries. By entering the contest, entrant accepts and agrees to abide by and be bound by the terms of these rules, and assumes sole liability and accepts all risk of loss for injuries, including personal injuries and/or damage to property, caused or claimed to be caused by participating in this contest or the acceptance, possession, or travel to or from or in connection with the contest or any prize awarded. Gemalto has the right to cancel, terminate or modify this contest for any reason, including if it cannot be completed as planned due to computer virus, bugs, tampering, unauthorized intervention or technical failures and to select winner from eligible entries received on or before the termination date. Gemalto is not responsible for any failure to contact entrants, whether due to technical or human error. Gemalto is not responsible for technical, hardware or software malfunctions, lost or unavailable network connections, or failed, incorrect, inaccurate, incomplete, lost, late, misdirected, illegible, mutilated, postage-due, garbled or delayed entries or other communications or other technical problems related to entries. Gemalto, in its sole discretion, reserves the right to disqualify any person who tampers with the entry process or the operation of the website, or who otherwise violates these rules. In the event of a dispute over who submitted an entry, the authorized subscriber of the e-mail account designated in the entrant's user account will be deemed to be the entrant. Use of multiple email addresses or multiple user accounts to enter is prohibited. Use of a false email address or a false user account, or an incorrect mail address will disqualify an entry. You may not allow any third party to make a submission in this contest using your user account. BY ENTERING THIS CONTEST, YOU AGREE THAT ALL SUSPECTED FRAUDULENT OR IMPROPER ENTRIES WILL BE DISQUALIFIED BY GEMALTO AT ITS SOLE DISCRETION. Entries become the property of Gemalto and will not be returned. Potential winners will be notified on or about May 12, 2009 by an email sent to the email address specified in the entry and posted on the JustAskGemalto website and JustAskGemalto Facebook profile. If potential winner cannot be contacted at this email, is contacted and does not respond as directed within seven (7) days of attempted notification, refuses the prize, is ineligible to accept the prize or does not otherwise comply with these rules, the prize may be forfeited and awarded to an alternate winner. Potential winner may be required to complete and sign a Commercial Video Release, an Affidavit of Eligibility and, except where and as prohibited, a Liability Release and a Publicity Release in the form provided by Gemalto, within seven (7) days of attempted notification in order to claim the prize. Potential winners may be required to show proof of identification within seven (7) days of attempted notification, or the prize may be forfeited and awarded to an alternate winner. In the case of a tie, the final selection will be left to the selection committee, whose decision will be final and binding. By entering this contest, entrants grant to Gemalto a worldwide, perpetual, irrevocable, right and royalty-free license to use the submission. Except where prohibited by law, entrants also grant to Gemalto a worldwide, perpetual, irrevocable, right and royalty-free license to use entrant's first and/or last name, city and state/province of residence, photo(s), voice and/or likeness; in any and all media but solely in connection with this contest. By entering this contest, entrants agree (a) that Gemalto has the right to exploit and utilize entrant's first and/or last name, city and state/province of residence, photo(s), voice and/or likeness in any and all media but solely in connection with this contest without any further attribution, notification or compensation to entrant, except where prohibited; (b) to be bound by these rules and the decisions of Gemalto; and (c) to be contacted by Gemalto or its agents by telephone, mail or email regarding this contest. By entering the contest, entrant releases and holds harmless Gemalto and its parent companies, subsidiaries, affiliates, and the directors, officers, employees or agents of each from any and all liability whatsoever for any claims, costs, injuries, losses or damages of any kind (including, without limitation, claims, costs, injuries, losses or damages related to personal injuries, death, damage to, loss or destruction of property, rights of publicity or privacy, defamation or portrayal in a false light) arising out of or in connection with the contest, the acceptance, possession, use, or misuse of any prize, or arising out of or in connection with any travel to or from any contest or prize related activity. Any and all claims, judgments and awards shall be limited to actual out-of-pocket costs incurred, including costs associated with entering this contest but in no event attorneys' fees; and entrant hereby waives all rights to claim punitive, incidental, and consequential damages and any other damages, other than for actual out-of-pocket expenses, and any and all rights to have damages multiplied or otherwise increased. SOME JURISDICTIONS DO NOT ALLOW THE LIMITATIONS OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO THE ABOVE MAY NOT APPLY TO YOU. In the event that any provision of these rules shall be unenforceable or invalid under any applicable law or be so held by applicable court decision, such unenforceability or invalidity shall not render these rules unenforceable or invalid as a whole, and, in such event, such provision shall be changed and interpreted so as to best accomplish the objectives of such unenforceable or invalid provision within the limits of applicable law or applicable court decisions. Information collected from entrants is subject to Sponsor's security and privacy policy available at www.justaskgemalto.com Open to individuals who are legal residents of the fifty United States and the District of Columbia who are 18 years of age or older or the age of majority in the entrant's state of residence, whichever is greater. Employees, officers, and directors of Gemalto, Inc., and its affiliated entities, parent, subsidiaries, advertising, promotional agencies, legal advisors, their immediate family members and persons living in their same household, are not eligible to enter or win. Void where restricted, taxed or prohibited by law. All federal, state, provincial, and local laws and regulations apply. Contest winner must be able to pass Gemalto.s standard background check and employment requirements and be able to prove eligibility to be employed in the United States. The contest is governed by the laws of the state of Texas applicable to contracts entered into by Texas residents and to be performed within such State without regard to its conflict of law provisions, with venue in Travis County, Austin, Texas.
	I agree to the above conditions

Eligibility and Release:	GEMALTO, INC. JOBLIKE ME CREATE YOUR VIDEO. CREATE YOUR CAREER. SUMMER INTERNSHIP CONTEST AFFIDAVIT OF ELIGIBILITY/LIABILITY AND PUBLICITY RELEASE NOTE: THIS RELEASE MUST BE AGREED TO BE THE APPLICANT AND SUBMITTED OR PRIZE WILL BE FORFEITED. You will need to agree to be bound by the following Affidavit of Eligibility/Liability and Publicity Release (the "Release"). The Release is a binding agreement without which you may not participate in the JobLikeMe Summer Internship Contest (the .Contest.) conducted by Gemalto, Inc. (.Gemalto.). THE RELEASE CONTAINS VERY IMPORTANT INFORMATION REGARDING CERTAIN WARRANTIES AND REPRESENTATIONS MADE BY YOU (ALL OF WHICH MUST BE TRUE FOR YOU TO PARTICIPATE THE CONTEST AND COLLECT THE PRIZE). BY AGREEING TO THIS RELEASE, YOU WILL BE RELEASING GEMALTO, INC. AND OTHERS OF LEGAL LIABILITY AND WAIVING CERTAIN OF YOUR RIGHTS. THEREFORE, BE CERTAIN THAT YOU CAREFULLY READ AND UNDERSTAND THE TERMS OF THIS RELEASE. IF YOU HAVE ANY QUESTIONS ABOUT THIS RELEASE OR ANY OF THE PROVISIONS CONTAINED IN IT, WE STRONGLY RECOMMEND THAT YOU CONSULT AN ATTORNEY. A. I am submitting this Release to Gemalto with the understanding that it will be relied upon to determine whether I am eligible to receive the prize in the Contest. As stated in the Contest Rules, attached hereto as Exhibit A, I understand that the prize will be as follows (.Prize.): i. Four (4) $500 VISA gift cards. ii. One (1) $1,000 cash prize. iii. A summer internship with Gemalto at its office in Austin, Texas (the .Internship.). Internship Dates: June 2009 through August, 2009 Internship Duration: 12 weeks (subject to the winner's compliance with Gemalto.s policies, end and stard date to be determined based upon scheduling) Internship Location: Austin, Texas Compensation: market salary, to be determined in the sole discretion of Gemalto, not to exceed US$12,000 total. Department/Division: rotation between Marketing and Business Reporting to: Manager Other: Please visit www.gemalto.com/joblikeme and Exhibit A: JobLikeMe Summer Internship Info Packet for description of internship duties, responsibilities and full benefits. Internship will be customizable to the winning intern, allowing the role to fluctuate to accommodate an individual area of study. Gemalto will work with the Intern as acceptable for the added benefit of gaining course credit. B. I, [name as completed in online form], state that the following information is true and accurate: i. My date of birth is: [as completed in online form] ii. The e-mail address I used to enter the Contest is: [as completed in online form] iii. My home telephone number is: [as completed in online form] iv. My home address is: [as completed in online form] v. I am enrolled and in good standing in a Bachelor or Master's degree program at [as completed in online form] vi. A legible photocopy of my valid driver.s license or other photo identification (.ID.) and proof of citizenship or legal right to work in the United States of America is attached. vii. I am not subject to any employment or other agreement which would interfere with my ability to accept the Internship if declared a winner; viii. I am not and have never been an employee, officer, director of Gemalto, Inc., or its affiliated entities, parent, subsidiaries, advertising, promotional agencies, or legal advisors. ix. I have never been a member of the immediate family of or a person living in the same household with an employee, officer, director of Gemalto, Inc., or its affiliated entities, parent, subsidiaries, advertising, promotional agencies, or legal advisors. C. In connection with Prize, I agree as follows: i. I am willing to authorize a background check, a criminal records/fingerprint review before starting the Internship in accordance with the applicable law; ii. I am willing to sign certain documents at the outset of the Internship, including without limitation, a confidentiality agreement; iii. I am willing to work for a minimum wage, without benefits; iv. I am willing to abide by, upon accepting the Internship, all relevant employment standards, practices, policies and procedures applicable to employees of Gemalto, Inc. and its affiliates. v. I acknowledge that Gemalto has not arranged for and does not carry any insurance of any kind for my benefit or that of my heirs, executors and administrators relative to my use of the Prize; and that I am solely responsible for obtaining and paying for any life, travel, accident, property or other insurance relative to my use of the Prize. D. General Disclaimers, Warranties and Representations i. I have not committed any fraud or deception in participating in the Contest, in completing this Release or accepting the Prize. ii. I have fully complied with the Contest Rules. iii. I assume sole liability and accept all risk of loss for injuries, including personal injuries and/or damage to property, caused or claimed to be caused by participating in this Contest or the acceptance, possession, loss, use or misuse of, or travel to or from or in connection with the Contest or any Prize awarded. iv. I ACKNOWLEDGE THAT THE VALUE OF THE PRIZE WILL BE TAXABLE TO ME AS INCOME. I ACKNOWLEDGE THAT ALL FEDERAL, STATE AND LOCAL TAXES ARE SOLELY MY RESPONSIBILITY. v. As provided in the Contest Rules, I consent to the use of my name, photograph and likeness for advertising and promotional purposes for this and similar promotions without additional compensation, except where otherwise prohibited by law. vi. I grant to Gemalto a worldwide, perpetual, irrevocable, right and royalty-free license to use the submission in the Contest. Except where prohibited by law, I also grant to Gemalto a worldwide, perpetual, irrevocable, right and royalty-free license to use my first and/or last name, city and state/province of residence, photo(s), voice and/or likeness; in any and all media but solely in connection with the Contest. I agree (a) that Gemalto has the right to exploit and utilize my first and/or last name, city and state/province of residence, photo(s), voice and/or likeness in any and all media but solely in connection with this Contest without any further attribution, notification or compensation to me, except where prohibited by applicable laws; (b) to be bound by the rules and the decisions of Gemalto; and (c) to be contacted by Gemalto or its agents by telephone, mail or email regarding the Contest or the Prize. vii. I, on my own behalf and on behalf of my heirs, next of kin, executors, administrators, successors and assigns, release, indemnify and hold harmless Gemalto and its agents and their respective parent companies, subsidiaries, affiliates, and the directors, officers, employees, marketing/promotional partners or agents of each (.Indemnitees.), from any and all liability whatsoever for any claims, costs, injuries, losses or damages of any kind, which I may have at present or which may occur at any time hereafter, known or unknown, suspected or unsuspected (including, without limitation, claims, costs, injuries, losses or damages related to personal injuries, death, damage to, loss or destruction of property, defamation or portrayal in a false light, libel, slander, intentional infliction of emotional distress, copyright infringement, violation of any right of privacy or publicity (statutory or otherwise)) arising out of, in connection with, or in any manner related to (a) the Contest; (b) the acceptance, possession, use, or misuse of the Prize, (c) while traveling to or from Prize related activity; (d) any use by Gemalto or any of its authorized designees, in whole or in part, of my submission in the Contest or any depiction thereof; (e) the exercise by Gemalto or any of its authorized designees of any of the rights granted by me in connection with this Contest; (f) my participation or inability to participate in the Contest; or (g) my use, misuse, inability to use or unwillingness to use any of the Prize awarded in the Contest. I hereby acknowledge that the Indemnitees have neither made nor are in any manner responsible or liable for any warranty, representation or guarantee, express or implied, in fact or in law, relative to the Prize or the Contest. I agree on my own behalf, and on behalf of my heirs, administrators, next of kin, executors, successors and assigns, that neither me nor any of the foregoing will make, assert or maintain against Indemnitees any claims related to any of the foregoing. viii. If any statements made by me in this Release or elsewhere are false, then in addition to any other remedies that may be asserted against me, I agree to forfeit my Prize in addition to all costs associated with re-awarding the Prize, including reasonable attorneys' fees. Without limitation of the forgoing, I agree to return any Prize or otherwise compensate Gemalto if any statement made by me is false, or if I breach any of the terms and conditions of this Release or Contest Rules. ix. In the event that any provision of this Release shall be unenforceable or invalid under any applicable law or be so held by applicable court decision, such unenforceability or invalidity shall not render this Release unenforceable or invalid as a whole, and, in such event, such provision shall be changed and interpreted so as to best accomplish the objectives of such unenforceable or invalid provision within the limits of applicable law or applicable court decisions. x. This Release is governed by the laws of the Texas applicable to contracts entered into by Texas residents and to be performed within such State without regard to its conflict of law provisions, with venue in Austin, Texas. xi. This Release, together with Commercial Video Release and Contest Rules, constitute the full and entire understanding and agreement between the parties regarding the subject hereof and thereof. I HAVE READ AND FULLY UNDERSTAND THIS RELEASE. MY ACCEPTANCE AND USE OF THE PRIZE ALSO CONSTITUTES MY ACCEPTANCE OF THE ABOVE TERMS AND THE TERMS OF THE CONTEST RULES. I declare that the foregoing is true and accurate.
	I have read and fully understand this release

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