EMPLOYMENT APPLICATION

    Applicant Information (Successful applicants will be required to take a drug test prior to the first day of employment)

    Name

    Address

    City/State

    Phone #

    Cell #

    Date available to start

    Salary Requirement

    Type of employment desired:

    Position applied for

    Do you know anyone currently or previously employed by Park Place?

    If yes, what is your relationship to them?

    Have you plead "guilty", "no contest" or been convicted of a crime?

    If yes, give dates and details

    Do you have a valid drivers license?

    Drivers License #

    Education

    High School Attended

    High School Graduate

    If you did not graduate, do you have GED

    College/Technical School

    Graduate

    Degree/Area of Study

    Summarize your special skills or qualifications:

    Previous employment (begin with most recent position)

    Date of employment:

    From

    to

    Firm

    City/State

    Position(s) held

    Starting Salary

    Ending Salary

    Reason for leaving

    Date of employment:

    From

    to

    Firm

    City/State

    Position(s) held

    Starting Salary

    Ending Salary

    Reason for leaving

    Date of employment:

    From

    to

    Firm

    City/State

    Position(s) held

    Starting Salary

    Ending Salary

    Reason for leaving

    I certify that my answers are true and complete. I authorize you to inquire and investigate my personal, employment , educational, financial and other related matters as necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.
    In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that a drug screening test will be required as part of the employment process.

    Signature of Applicant

    Date