Position Applying for / GAMING LISTN/ADealer Inspector (21)Gaming Floor Technician (91)Gaming Manager (18)Inspector Dealer (22)Pit Boss (19)Assisant Pit BossCashierCsh Desk ManagerSurveillance Officer / Photo
Relative previous experience / Yr Mth
How you heard of the vacancy / SELECTFamilyFriendJob CentreNews PaperSearch EngineSpeculativeWeb Job BoardOther
Application Date
PERSONAL DETAILS
Surname* / Forename*
Address Line 1 / Known as
Address Line 2 / Title / SELECTDrMissMrMrsMs
Address Line 3 / Email Address*
Town / Home Phone
County / Mobile Phone*
Post Code / NI Number
MIGRANT DETAILS
Migrant* / SELECTNoYes
Migrant Category* / SELECTEEA Country MigrantTier 1 : Highly SkilledTier 2 : Skilled with OtherTier 3 : Low SkilledTier 4 : StudentTier 5 : Youth + TempsSpousal Visa
Entry Date*
EMPLOYMENT PERSONAL DETAILS
Do you have relatives or partners in our employment?* / SELECTNoYes
Have you applied to this company before?* / SELECTNoYes
Notice Period in weeks*
Have you had any condition that might affect your ability to carry out your duties in relation to the position applied for?* / SELECTNoYes
Languages Spoken (please list all)*
EDUCATION
Name of School/College / Address / Examinations (Subject/qualifications) / Date from / Date to
EMPLOYMENT HISTORY (most recent first) *
Company / Address / Telephone Number / Position / Salary / Date from / Date to / Reason for leaving
Duties
Duties
Duties
Duties
Duties
Duties
Duties
Reason for gaps between employments
CASINO GAMES EXPERIENCE *
Game / Deal how long / Inspect how long / When Trained / Where Trained
Blackjack / Yr Mth / Yr Mth
Blackjack: 21+3 / Yr Mth / Yr Mth
Blackjack: Top 3 / Yr Mth / Yr Mth
Blackjack: Perfect Pair / Yr Mth / Yr Mth
Punto Banco (various side bets) / Yr Mth / Yr Mth
Punto Banco Rolling Program / Yr Mth / Yr Mth
American Roulette / Yr Mth / Yr Mth
Dice / Yr Mth / Yr Mth
CSP/TCP / Yr Mth / Yr Mth
TCP: Prime Bet / Yr Mth / Yr Mth
Other / Yr Mth / Yr Mth
TRAINING AND QUALIFICATIONS (relevant to role)
Organisation / Course / Result / Date Obtained
EMPLOYMENT LICENCE DETAILS *
Licence / Reference ID / Date Issued / Renewal Date
Combined Functional Management
Liquor Personal
Personal Functional
Personal Management
CRIMINAL RECORD DETAILS *
Conviction / Offence / Date / Court/Penalty
Cautions
Have you ever received any caution/s or warning/s from the gaming commission? SELECTNoYes
REFERENCES *
Two work based references, including you most recent employer.
Name / Address / Telephone number / Email Address / Contact prior to Interview? / Job Title
SELECTNo
SELECTNo
SELECTNo
WORKING TIME *
Shift Working / Full Time / Part Time / Casual / Zero Hours / Permanent / Temporary
SELECTNoYes / SELECTNoYes / SELECTNoYes / SELECTNoYes / SELECTNoYes / SELECTNoYes
PROFILE
Please describe the skills, behaviours and experience you have that make you the best person for the role, giving practical examples.

By submitting this application I confirm that the information I have given is to the best of my knowledge true and complete. Any false statement may be sufficient cause for rejection or if employed, dismissal. I consent to this information being held on file under the terms of the Data Protection Act 1998.

Surname
Date

ALL AREAS MARKED WITH * MUST BE COMPLETED. PLEASE CHECK YOUR APPLICATION BEFORE APPLYING, INCOMPLETE APPLICATIONS WILL BE REJECTED. APPLICATION FORMS ARE ONLY HELD ON RECORD FOR 6 MONTHS.

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The completed application should be saved as a word document and emailed to