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Position

Expected Salary *

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First Name: *

Middle Name:

Last Name: *

Maiden Name: (if applicable)

Aliases: (if used)

Permanent Address: *

City: *

State: *

ZIP Code: *

Daytime Phone Number: *

Evening/Secondary Phone Number:

Due to the nature of the work, some positions may require the employee be at least 18 years of age.

Are you at least 18 years old? *

Other:

Are you employed now? *

Yes

If so, can we contact your present employer? *

Yes

Type of employment seeking? *

Full-Time

Part-Time

Available Start Date

Have you ever applied for employment at Kirke Financial Services or Wild Rose Casino & Resort? *

Yes

If yes, please list employment dates, occupation(s) and reasons for leaving:

Do you have any relatives employed by KFS or WRCR? *

Yes

If yes, please list name, company, position and location:

Are you legally permitted to work in the United States? *
Proof of citizenship and immigration status will be required upon employment.

Yes

Have you ever pled guilty, "no contest" or received a deferred sentence? *

Yes

Are you currently named as a defendant in a criminal indictment? *

Yes

If you answered yes to either of the above questions, please explain:

Have you ever been licensed at another gaming facility?? *

Yes

If yes, which facility:

School Name *

Years *

Graduated? *

Courses Studied / Degree *

Employer Name

Address

Job Title

Supervisor

Phone

Relationship

Occupation

Years

I am available to work

1st Shift

2nd Shift

3rd Shift

Will you work overtime if asked? *

Yes

Will you work evenings and weekends if asked? *

Yes

Will you work any scheduled hours? *

Yes

Applicant Initials: *

Lift or carry up to 35 pounds? *

Yes

Ability to read, speak and/or interpret simple sentences in English? *

Yes

Wear proper uniforms in department where such uniforms are required according to department policies?? *

Yes

Work effectively and perform routine job tasks in a sometimes noisy, smoke-filled environment? (Must be able to work nights, weekends and holidays)

Yes

Move your body by stooping, kneeling, bending or crouching? *

Yes

Tilt neck in either a sit or stand position at angles for extended periods of time, as required, for up to 12 hours? *

Yes

Use your hands or fingers to handle or feel any of the following: operating keyboards, controls, cards, coins, chips, simple grasping, firm grasping or fine pinching? *

Yes

Reach with hands and arms above the shoulder and head, shoulder level, waist level and below waist level? *

Yes

Be able to complete tasks that require repetitive motion with wrist (forearm twisting/flexing), elbow, shoulder and neck? *

Yes

Stand and walk about for long periods of time (up to 12 hours)? *

Yes

Willing to attend training related to your position? *

Yes

Are there any reasons why you would not be able to perform the essential functions described? *

Yes

If you need to provide more detail to your responses above, please use the box below: *

Applicant Signature: *

Phone

Relationship

Occupation

Years

Company Name

Address

Job Title

Supervisor

Position

Expected Salary

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