Volunteers in Key Positions only must complete this form. This form must be completed in full.
Please print clearly
NAME OF ORGANIZATION
DATE(S) OF CASINO
KEY POSITIONS: (must check one)
General Manager Alt General Manager
Count Room Supervisor
Paid staff of the licensed organization can work, provided:
a. they are members of the organization as defined by their bylaws;
b. they volunteer their services outside normal working hours;
c. they do not fill the following positions: General Manager, Alternate General Manager, Banker, Count Room Supervisor;
d. no individual shall work more than one position during the licence period of the casino; and
e. all personnel shall be eighteen (18) years of age or older.
PARTICULARS OF VOLUNTEER
Other or Maiden Name
Date of Birth (yy/mm/dd):
Place of Birth:
HAVE YOU EVER BEEN CHARGED OR CONVICTED OF A CRIMINAL OFFENCE?
No individual is eligible to work in a casino if charged or convicted, within the last five years, of a criminal offence related to narcotics or to acts of dishonesty, including but not limited to offences involving fraud, currency, or gaming and betting or those against the rights of property (such as theft, robbery, forgery), or fire arms and offensive weapons, or an indictable offence for an act of violence against a person. If five years after conviction an individual is still under sentence for such an offence, approval shall not be given under this application until completion of sentence. AGLC may contact police for relevant information about the applicant. If an individual has received a pardon under provisions of the Criminal Records Act, this policy will not apply.
I certify that the information in this application and any attachments are true, correct and complete to the best of my knowledge and belief. I understand that any false statement made in this application and any attachments may disqualify me from working at a casino. I hereby consent to and authorize the AGLC to undertake a criminal record check, with any police agency, to determine my eligibility to be involved in gaming facilities, in…