Employment Application | Prairie Moon Casino

Job Titles

Please select the job positions you are interested in from the drop-down menu below (you may select more than one option):

Full Name

First Name:

Middle Name:

Last Name:

Date of Birth:

Today's Date:

Address

Street Address:

Apartment/Unit:

City:

State:

ZIP Code:

Phone:

E-mail Address:

Education

High School:

Address:

From:

To:

Did you graduate? YesNo

College:

Address:

From:

To:

Did you graduate? YesNo

Degree:

Other:

Address:

From:

To:

Did you graduate? YesNo

Degree:

References

Please list three professional references.

Full Name:

Relationship:

Company:

Phone:

Address:

Full Name:

Relationship:

Company:

Phone:

Address:

Full Name:

Relationship:

Company:

Phone:

Address:

Previous Employment

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? YesNo

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? YesNo

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? YesNo

Military Service

Branch:

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Background

Would you be able to pass a background check? YesNo

Why?

A drug screening may be included at the time of hire. Marijuana will not be tested.

Resume

Upload a resume as an attachment:

Driver's License

Copy of a valid driver's license:

Disclaimer

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature

Signature:

Date:

* Please sign the form electronically on the next page after submitting here.