General Employment Application | Lucky Street Gaming

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Phone

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PERSONAL DATA

Application Date*

Application Date *

Name*

Address*

Home Phone*

Cellular / Other Phone

Email Address*

Are you legally eligible for employment in the United States?*

(If yes, proof is required if hired)

Are you 21 years of age or older?*

Position(s) applying for:*

Do you have a current and active Terminal Handler’s license?*

Have you entered into an agreement with any former employer or other party (such as a non-compete agreement) that might, in any way, restrict your ability to work for Lucky Street Gaming, LLC?*

If yes, please explain:

Do you hold a valid Driver’s License?

Driver’s License #

State

If hired, on what date can you start work?

EDUCATIONAL RECORD

High School

High School Address

Did you graduate?

Trade or Technical Training

Trade or Technical Training Address

Trade or Technical Training Degrees or Diplomas

College / University

College / University Address

College / University Diplomas

EMPLOYMENT HISTORY

Please list your most recent employer and fill in every line.

Employment

Employer

Dates of Employment

Employer Address

Employer Phone

Supervisor

Title / Duties

Reason for Leaving

SPECIAL SKILLS

Summarize any special skills or qualifications that you acquired through employment or other experience that are applicable to the job that you are applying for:

List any professional, trade, business or civic activities and offices held. (Please exclude groups which include sex, race, religion, national origin, citizenship, age or disability).

Summarize any certifications, apprenticeships, and/or formal training received.

MILITARY

Are you a veteran of the U.S. Military Service?

If yes, when?

You are available to work:

Are you or have you ever been employed by FMG?

If so, hire date:

Are you related to or do you know anyone currently employed by Lucky Street Gaming LLC?

If yes, who?

Do you have the ability to perform all tasks outlined within the job description for the position(s) for which you are applying (with or without reasonable accommodation)?

REFERENCES

Reference 1

I certify that I have not knowingly withheld any information that might adversely affect my chances for employment and all of the information submitted by me on this application are true and complete and to the best of my knowledge. I understand that supplying any false or misleading information, omissions or misrepresentations herein shall result in immediate disqualification for consideration for employment or termination from employment, regardless of when such false information is discovered.

If hired, I agree to conform to Lucky Street Gaming LLC’s rules and regulations, and I understand that these rules and/or the employee personnel manual do not form a contract of employment either express or implied, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at either my or Lucky Street Gaming LLC’s option. I understand that neither this document nor any offer of employment from the employer constitutes an employment contract, unless a specific document to that effect is executed by the employer and employee in writing. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by Lucky Street Gaming LLC. I understand that only Lucky Street Gaming LLC’s CEO or COO or designated representative, and then only when in writing and signed by president or said representative, has the authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing.

I expressly authorize, without reservation, Lucky Street Gaming LLC, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby waive any and all rights and claims I may have regarding Lucky Street Gaming LLC’s, its agents, employees or representatives for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this application remains current for a period of only 30 days. At the conclusion of that time, consideration of employment will require a new employment application to be completed and submitted to Lucky Street Gaming LLC.

I also understand that if I am selected for employment, I will be required to provide proof of identity and legal authorization to work in the United States as required by federal immigration laws.

Lucky Street Gaming LLC is an Equal Employment Opportunity Employer and does not tolerate unlawful discrimination or harassment based on sex, race, religion, national origin, citizenship, age, disability or any other protected status under applicable federal, state or local laws. No question on this application is used to limit or exclude an applicant from employment consideration on any basis prohibited by applicable federal, state or local law.

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