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Employment Application

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The Gold Dust Gaming Complex is an equal opportunity employer. Applicants are considered for employment without regard to sex, marital status, race, color, religion, creed, national origin, age, physical or mental disability.

Employment History

Please list your most recent position first.

Employer Name:
Employer Address:
Employer Phone:
Supervisor Name:
Reason For Leaving:
Job Title:
Start Date:
End Date:
May we contact this employer?	Yes No
Summary of work performed:

Employer Name:
Employer Address:
Employer Phone:
Supervisor Name:
Reason For Leaving:
Job Title:
Start Date:
End Date:
May we contact this employer?	Yes No
Summary of work performed:

Employer Name:
Employer Address:
Employer Phone:
Supervisor Name:
Reason For Leaving:
Job Title:
Start Date:
End Date:
May we contact this employer?	Yes No
Summary of work performed:

Special Skills

Summarize any special skills, qualifications, and equipment used:
Do you have transportation to this job?	Yes No
Driver's License Number:
State/Type:

Personal/Professional References

Name:
Address:
Phone:
Occupation:
Length of Acquaintance:

Name:
Address:
Phone:
Occupation:
Length of Acquaintance:

Name:
Address:
Phone:
Occupation:
Length of Acquaintance:

Other

Additional comments you feel would assist us in evaluating your qualifications:
Are you willing to relocate?	Yes No

Application Statement

I verify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview (s) may result in discharge. Necessary for employment in a specific position, you may be required to have a physical examination, drug screen, to provide evidence of citizenship or date of birth, or to sign a conflict of interest agreement and abide by its terms.

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*First Name:
Middle Initial:
*Last Name:
*Address:
Address 2:
*City:
*State:
*ZIP:
*Phone:
Alternate Phone:
Fax:
*Email:
*Job Applied For:
*Salary Desired:
*Are you a United States citizen?	Yes No**
**If no, Alien Registration number:
*I am looking for:	Full Time Part Time Temporary
*I prefer to work:	Days Evenings Nights Weekends Any
*If necessary for the job, are you:	18 or older 21 or older 25 or older
*Do you have a South Dakota Gaming License?	Support Key None
*Have you served in the U.S. Military?	Yes** No
**If yes, Branch of service:
**From:
**To:
**Duties and training while in service:

High School Years Completed:	9th 10th 11th 12th GED
Diploma/Degree/Certificate:
Other Education/Training:
Major:

College Years Completed:	One Two Three Four
Diploma/Degree/Certificate:
Other Education/Training:
Major:

Graduate/Professional Years Completed:	One Two Three Four
Diploma/Degree/Certificate:
Other Education/Training:
Major:

Gold Dust, Deadwood SD

Employment Application