Personal Information Prospective employees will receive consideration without discrimination
because of race, creed, color, sex, age, national origin, handicap or veteran status.
Last Name:
First Name:
Middle Name:
Date:
Street Address:
City: State: Zip:
Home Telephone:
Business Telephone:
Have you ever applied for employment with us? Yes No
If yes: Month/year :
Location:
Position Desired:
Apart from absence for religious observance, are you available for full-time work?
Yes No
If not, what hours can you work?
When will you be available to begin work?
Are you legally eligible for employment in the United States? Yes No
Other special training or skills (languages, machine operation, etc.)
Social Security Number:
Pay Expected:
Will you work overtime if asked? Yes No
Employment History Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.
1. Company Name:
Name of Supervisor:
Job Title and Description:
Telephone:
Employed (state month & year) from to
Weekly Pay: start last
Reason for Leaving:
2. Company Name:
3. Company Name:
Imperial Casino Hotel PO Box 869, 123 N. 3rd St., Cripple Creek, Colorado 80813 1-800-235-2922 719-689-7777
