APPLICANT QUESTIONNAIRE Are you at least 18 years of age? Yes No Thank you for your interest in employment at 7th Street Casino. Applicants must meet the previous criteria to proceed with the application process.Are you willing to comply with a full and complete background check in order to obtain a gaming license? I agree, Yes No Thank you for your interest in employment at 7th Street Casino. Applicants must meet the previous criteria to proceed with the application process.Have you ever been convicted of a crime? Yes No Thank you for your interest in employment at 7th Street Casino. Applicants must meet the previous criteria to proceed with the application process. Position(s) Interested In*Please check all that apply. Any / All Applicable Bartender Cage/Vault Cashier F&B Supervisor Maintenance Technician Marketing Coordinator Operations Compliance Officer Player's Club Rep Pull/Count Team Specialist Security Officer Security Supervisor Slot Attendant Name* First Middle Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How Long at Current Residence Telephone*Alternate NumberEmail Address example: name@domain.comPlease list all additional address for the past five (5) years and dates.Example: 123 Street Kansas City, KS 66101 from 01/25/2016 to 02/12/2017Please list other legal name(s) used and dates used (no nicknames).How did you hear about the position(s) at 7th Street Casino?Please check all that apply. Radio / TV Indeed FaceBook Casino Employee Walk-In Other If "Casino Employee" please name employee. If "other" please describe. Are you a Native American tribal member? Yes No If "Yes", what Tribe? What date can you start work? MM slash DD slash YYYY Desired Hourly Wage Availability: Note the casino is open 24 hours per dayAvailabilityPLease check all that apply. Full-time Part-time Days of the Week*Please check all days you are available to work. *Note: All schedules include weekends and holiday hours. Saturday Sunday Monday Tuesday Wednesday Thursday Friday TimePlease check all shifts you are available to work. *Note: Our peak hours are nights and weekends. Day Evening Overnight Are you related to anyone who works at 7th Street Casino? Yes No If "Yes" please disclose name and relationship. This includes stepfamily members, half siblings and extended family.Have you ever been employed by 7th Street Casino or Wyandotte Nation Casino? Yes No High School EducationHigh School / Address / City & StateNumber of Years Attended Graduated? Yes No College EducationCollege / City & StateNumber of Years Attended Graduated? Yes No Subjects / Degree(s) EarnedTrade, Business or Correspondence EducationCollege / City & StateNumber of Years Attended Graduated? Yes No Subjects / Degree(s) EarnedOther Special Studies, Training, Skills, CertificationsExample: Computer Hardware/Software Applications, Professional/Trade/Industry Certifications, Clerical/Administrative SkillsEmployment HistoryBeginning with the most recent employer, list the last five (5) years of employment. Include Street Address, City, state and Zip Code. Are you employed now?* Yes No Employment From MM slash DD slash YYYY Employment To MM slash DD slash YYYY Employer Name and Address*Employer, City, State ZipBusiness PhoneSalary Job Titles and DutiesMay we contact this employer? Yes No Supervisor Name / Title Previous JobEmployment From MM slash DD slash YYYY Employment To MM slash DD slash YYYY Employer Name and AddressEmployer, City, State ZipBusiness PhoneSalary Reason for LeavingMay we contact this employer? Yes No Job Titles and DutiesSupervisor Name / Title Second Previous JobEmployment From MM slash DD slash YYYY Employment To MM slash DD slash YYYY Employer Name and AddressEmployer, City, State ZipBusiness PhoneSalary Reason for LeavingMay we contact this employer? Yes No Job Titles and DutiesSupervisor Name / Title Third Previous JobEmployment From MM slash DD slash YYYY Employment To MM slash DD slash YYYY Employer Name and AddressEmployer, City, State ZipBusiness PhoneSalary Reason for LeavingMay we contact this employer? Yes No Job Titles and DutiesSupervisor Name / Title ReferencesName of Three (3) person, OTHER THAN FRIENDS AND RELATIVES, you have know for at least one year (i.e. Managers, Supervisors, Co-Workers, Case Workers and/or Pastors).Name PhoneCompany / Job Title Business / Work Relationship Years Known Second ReferenceName PhoneCompany / Job Title Business / Work Relationship Years Known Third ReferenceName PhoneCompany / Job Title Business / Work Relationship Years Known Military ServiceBranch of Service Discharge Date MM slash DD slash YYYY Rank Type of education, training, work experience received while in serviceDo you have reliable transportation?* Yes No Do you have any issues working in a smoke-friendly environment?* Yes No Are you available to work Nights, Weekends and Holidays?* Yes No Are you able to stand, walk and utilize stairs throughout an 8 hour shift?* Yes No Why do you want to work for 7th Street Casino?*AuthorizationI certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. Incomplete applications may not be considered for further review. I authorize investigation of all statements contained herein and the references and employers listed to give any and all pertinent information concerning my previous employment. I hereby authorize 7th Street Casino to make any investigation of my personal history, educational background, military background, credit records, work history and criminal records. I hereby release 7th Street Casino and Wyandotte Nation from all liability for any damage that may result from utilization of such information. I understand that I can terminate my employment at any time with or without prior notice and that my employ- ment can be terminated by 7th Street Casino at any time for any reason, and that I am considered an at-will em- ployee for purposes of employment with 7th Street Casino. I also understand that no representative of 7th Street Casino or Wyandotte Nation has the authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.*SignatureConditionsI agree that a photocopy of this authorization may be used for the purposes stated above. The original of this authorization is on file and will stay in effect for a year and one month from the date signed. The 7th Street Casino has the right to review this file and correct any information that is incorrect. I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.*SignatureNOTIFICATION OF PHYSICAL REQUIREMENTSI understand that the position that I am applying for will require me to work inside the casino, which is a smoking facility and has constant noise. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. 2. 3. 4. 5. 6. I agree that could result Ability to stand, and or walk for approximately 8 hours and take a minimum of 80 (eighty) stairs for entirety of shift as required to conduct normal assigned duties Ability to lift, push, pull, bend, squat or carry 35# (thirty-five pounds) in emergency situations Ability to function in a smoking environment Employee smoking is restricted to outside location and during break times Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus The noise levels in the work environment are constant I can adhere to the physical requirements stated above and that failure to meet these requirements in termination of my employment.*SignatureEmailThis field is for validation purposes and should be left unchanged. Δ
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