Employment Application


Fill out this form as a preliminary inquiry into employment at the Long Island Game Farm. You will be contacted as soon as possible if you qualify for a position.

Personal Information
Full Name
Address
City	State Zip
Phone Number	Email Address
Referred By

Employment Desired
Position Desired
Start Date	Salary Desired
Days Available Mon Tues Wed Thurs Fri Sat Sun
Are you 16 years of age or older? Yes No
Are you 18 years of age or older? Yes No
Have you ever applied to the Long Island Game Farm before? Yes No
If so, when?

Education History
Subjects of special studies, work, or special training
Military/Naval Service	Rank

Former Employers
List your last two employers, with the most recent one first.
Name of Employer
Full Address
Phone Number	Dates Employed
Position	Salary
Reason For Leaving

Name of Employer
Full Address
Phone Number	Dates Employed
Position	Salary
Reason For Leaving

Resume
If available, please paste your full resume in the box below.

Authorization
I certify that the information contained in this application is true and complete to the best of my knowledge and understand that any falsified statements on this application shall be grounds for dismissal.
Type the code in the box below:

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