CONFIDENTIAL
APPLICATION FOR EMPLOYMENT
OTB ADHERES TO ALL EEO PROTECTIONS,
AS PROVIDED BY CITY, STATE AND FEDERAL LAWS.
OTB IS AN EQUAL OPPORTUNITY EMPLOYER
PERSONAL DATA (PLEASE PRINT OR TYPE)
* NAME (LAST) * FIRST
MIDDLE INITIAL * EMAIL ADDRESS
ADDRESS APARTMENT NUMBER
CITY/BOROUGH STATE
ZIP CODE HOME PHONE NUMBER
BUSINESS PHONE NUMBER SOCIAL SECURITY NUMBER
 

YOUR JOB REQUIREMENTS
TYPE OF WORK DESIRED: 
CHECK AS APPLICABLE
 MINIMUM ACCEPTABLE SALARY:
$ PER ANNUM
$ PER HOUR (FOR P/T ONLY )

THE FOLLOWING CONDITIONS MAY BE REQUIRED AT SOME POINT IN A JOB ASSIGNMENT. IF REQUIRED, WOULD YOU BE WILLING TO WORK:
A. VARIABLE WORK LOCATIONS? B. OVERTIME WORK?
C. HOLIDAY WORK? D. ROTATING WORK SCHEDULE?
E. WORK SCHEDULE OTHER THAN
MONDAY THROUGH FRIDAY?		    
IF NO, PLEASE EXPLAIN:
DO YOU HAVE ANY COMMITMENTS TO ANOTHER EMPLOYER, INDIVIDUAL, OR SCHOOL, WHICH MIGHT AFFECT YOUR EMPLOYMENT WITH US?

IF YES, PLEASE EXPLAIN
WHEN COULD YOU BE AVAILABLE TO BEGIN WORK?    
 

GENERAL INFORMATION

PLEASE CHECK IF YOU ARE: 

VETERAN STATUS U.S. VETERAN  

IF YES, DATES OF SERVICE FROM:     /     TO      /       (MO/YR )
BRANCH OF SERVICE ARE YOU IN THE RESERVES?  
 

1. HAVE YOU EVER BEEN EMPLOYED BY OTB?

IF YES, PLEASE SPECIFY AND GIVE DATES:
 
2. DO YOU HAVE ANY RELATIVES CURRENTLY EMPLOYED BY OTB?         
IF YES, PLEASE GIVE NAME AND RELATIONSHIP:
 
3. ARE YOU CURRENTLY RECEIVING A NEW YORK CITY OR NEW YORK STATE PENSION?        
 
4. DO YOU ANTICIPATE ANY INCOME DURING THE NEXT 12 MONTHS FROM ANY SOURCES THAT MAY CONSTITUTE A CONFLICT OF INTEREST IN CONNECTION WITH YOUR EMPLOYMENT WITH NYCOTBC?
IF YES, PLEASE EXPLAIN:
 

EMPLOYMENT EXPERIENCE

PLEASE LIST YOUR JOB HISTORY FOR THE PAST TEN YEARS (OR LAST FIVE EMPLOYERS). START WITH YOUR PRESENT STATUS AND NOTE ANY PERIODS IN WHICH YOU WERE NOT EMPLOYED. INCLUDE PREVIOUS OTB EXPERIENCE, SUMMER AND PART-TIME JOBS, VOLUNTEER WORK AND COOPERATIVE EDUCATION ASSIGNMENTS.
 
COMPANY NAME, ADDRESS TELEPHONE NUMBER DATES
EMPLOYED MONTH/YEAR		 BASE RATE OF PAY POSITION HELD, (IF P/T OR VOLUNTEER, SO STATE) NAME, TITLE OF IMMEDIATE SUPERVISOR
NAME
FROM:
TO:
STARTING $ PER
FINAL $ PER
ADDRESS
REASON FOR LEAVING
NAME
FROM:
TO:
STARTING $ PER
FINAL $ PER
ADDRESS
REASON FOR LEAVING
NAME
FROM:
TO:
STARTING $ PER
FINAL $ PER
ADDRESS
REASON FOR LEAVING
NAME
FROM:
TO:
STARTING $ PER
FINAL $ PER
ADDRESS
REASON FOR LEAVING
NAME
FROM:
TO:
STARTING $ PER
FINAL $ PER
ADDRESS
REASON FOR LEAVING
 
ARE YOU CURRENTLY WORKING FOR ANY CITY, STATE OR FEDERAL AGENCY?    IF YES, PLEASE BE ADVISED THAT YOU MUST SUBMIT A CERTIFICATE OF DUAL EMPLOYMENT IF SUCH EMPLOYMENT CONTUNUES BEYOND YOUR OTB HIRE DATE.
DO YOU HAVE ANY OBJECTIONS TO OUR CONTACTING YOUR PRESENT EMPLOYER TO VERIFY THE ABOVE?
HAVE YOU EVER BEEN DISMISSED FROM A POSITION, OR RESIGNED FROM A POSITION IN LIEU OF DISMISSAL? IF YES, EXPLANATON:
PLEASE INCLUDE ANY OTHER INFORMATION YOU THINK WOULD BE HELPFUL IN CONSIDERING YOU FOR EMPLOYMENT. INCLUDE WORK EXPERIENCE, LICENSES, LANGUAGES SPOKEN, ASSOCIATIONS, ACCOMPLISHMENTS, ETC.
DO YOU HAVE A VALID DRIVER'S LICENSE?   
TYPE STATE ISSUED
IDENTIFICATION # EXPIRATION DATE
 
EDUCATION AND TRAINING
(PROVIDE ALL APPLICABLE INFORMATION IN THE SECTIONS BELOW)
HIGH SCHOOL GRADUATED?     GED    
NAME OF SCHOOL ADDRESS
IF YOU DID NOT GRADUATE, OR RECEIVE A GED, PLEASE INDICATE THE LAST FULL YEAR OF SCHOOLING COMPLETED ( E.G. 8TH GRAGE, 10TH GRADE, ETC.)
COLLEGE      
UNDERGRADUATE DEGREE?
TYPE OF DEGREE
IF NO, # OF CREDITS COMPLETED OTHER
NAME OF SCHOOL ADDRESS
GRADUATE SCHOOL      
GRADUATE DEGREE?  
TYPE OF DEGREE
NAME OF SCHOOL ADDRESS
SPECIAL TRAINING
   
INSTITUTE CERTIFICATE
SUBJECT STUDIED # OF HOURS OF INSTRUCTION
IN CASE OF EMERGENCY, PLEASE CONTACT THE FOLLOWING:
NAME TELEPHONE NUMBER
NAME TELEPHONE NUMBER
 
SECURITY DATA SHEET
QUESTIONS 1-3 RELATE TO CONVICTIONS ONLY. DO NOT INCLUDE ARRESTS WITHOUT CONVICTONS IN YOUR ANSWER.
1. HAVE YOU BEEN CONVICTED OF ANY FELONIES?
2. HAVE YOU EVER BEEN CONVICTED OF A GAMBLING OFFENSE?
3. HAVE YOU BEEN CONVICTED OF ANY OTHER CRIME WITHIN THE LAST TEN YEARS?
IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, PLEASE BRIEFLY DESCRIBE IN THE SPACE PROVIDED BELOW, THE CIRCUMSTANCES OF EACH CONVICTION, INDICATING THE DATE, NATURE AND PLACE OF THE OFFENSE AND DISPOSITION OF THE CASE. YOUR ANSWER IS LOOKED UPON AS ONLY ONE OF THE FACTORS CONSIDERED IN THE EMPLOYMENT DECISION AND IS EVALUATED IN TERMS OF THE NATURE, SEVERITY, RECENCY OF THE OFFENSE, AND ITS JOB RELATEDNESS. YOU MUST INCLUDE ANY MOTOR VEHICLE CONVICTIONS.
4. ARE THERE ANY CRIMINAL CHARGES PENDING AGAINST YOU CURRENTLY?
IF YES, GIVE EXPLANATION
5. HAVE YOU EVER USED ANY OTHER NAME (INCLUDING A MAIDEN NAME) ?
IF SO, GIVE NAME AND DATES USED.
6. HAVE YOU FILED ALL REQUIRED FEDERAL, STATE AND CITY INCOME TAX RETURNS FOR THE PAST THREE YEARS?
EXPLANATION:  
 
CONDITIONS APPLICABLE TO ALL EMPLOYEES
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY: THEY CONSTITUTE CONDITIONS OF EMPLOYMENT WITH THE NYCOTBC.
  1. I UNDERSTAND AND AGREE THAT:
    1. ANY MATERIAL MISREPRESENTATION OR DELIBERATE OMISSION OF A FACT IN MY APPLICATION MAY BE JUSTIFICATION FOR REFUSAL OF, (OR IF EMPLOYED, TERMINATION FROM) EMPLOYMENT WITH THE NEW YORK CITY OFF-TRACK BETTING CORPORATION.
    2. ALL APPLICATIONS OR APPOINTMENTS ARE SUBJECT TO INVESTIGATION. I UNDERSTAND THAT I MUST MEET THE MINIMUM REQUIREMENTS FOR THE POSITION AND THAT MEDICAL STANDARDS, SATISFACTORY CHARACTER AND REPUTATION SHALL BE DEEMED A PART OF THE ESTABLISHED MINIMUM REQUIREMENTS. I FURTHER UNDERSTAND THAT I MAY BE REQUIRED TO PRODUCE DOCUMENTATION RELATIVE TO MY APPLICATION AND APPOINTMENT. FAILURE TO PRODUCE THE REQUIRED DOCUMENTATION, OR OTHERWISE COOPERATE, MAY BE GROUNDS FOR DISQUALIFICATION OR TERMINATION, IF APPOINTED.
    3. OTB IS CURRENTLY A SEVEN-DAY-A-WEEK OPERATION. BUSINESS NEEDS MAY, AT TIMES, MAKE THE FOLLOWING CONDITIONS MANDATORY: OVERTIME, OCCASIONAL CHANGES IN ASSIGNED WORK SCHEDULE, HOLIDAY WORK, OR A WORK SCHEDULE THAT MAY INCLUDE SATURDAY OR SUNDAY AND/OR EVENING HOURS. I UNDERSTAND AND ACCEPT THIS AS CONDITIONS OF MY EMPLOYMENT.
    4. WHEN CONDITIONS WARRANT, I MAY BE INVOLUNTARILY TRANSFERRED TO ANOTHER BRANCH OR DEPARTMENT. SUCH TRANSFERS WILL BE MADE IN ACCORDANCE WITH CONTRACTUAL AGREEMENTS AND/OR CIVIL SERVICE RULES AND REGULATIONS.
    5. MY FIRST YEAR OF EMPLOYMENT IS PROBATIONARY (UNLESS OTHERWISE SET FORTH IN THE TERMS AND CONDITIONS FOR APPOINTMENT AS DETERMINED BY THE OTB CIVIL SERVICE COMMISSION). DURING THE LAST TEN MONTHS OF MY PROBATIONARY PERIOD, MY EMPLOYMENT MAY BE TERMINATED WITHOUT RECOURSE. MANAGEMENT PAY PLAN EMPLOYEES HAVE NO PROBATIONARY PERIOD AND CONTINUATION OF THEIR EMPLOYMENT IS AT THE DISCRETION OF THE PRESIDENT.
    6. THE NYCOTBC UNIFORM RULES OF DISCIPLINE WILL GOVERN MY CONDUCT AND PERFORMANCE WHILE EMPLOYED BY OTB. FAILURE TO ADHERE TO SUCH RULES SUBJECTS ME TO DISCIPLINARY ACTION.
    7. I UNDERSTAND THAT AS A CONDITION OF APPOINTMENT OR CONTINUED EMPLOYMENT, I MUST DISCLOSE ALL EXISTING DEBTS TO THE CITY OF NEW YORK AND WILL CONSENT TO PAYROLL DEDUCTIONS IN ORDER THAT THE CITY RECOVER ANY AMOUNTS OWED.
    8. I UNDERSTAND I WILL BE REQUIRED TO PAY FICA (SOCIAL SECURITY) DEDUCTIONS.
    9. OTB IS AN AT-WILL EMPLOYER AND ANY OFFER OF EMPLOYMENT DOES NOT CONSITITUTE A WRITTEN OR IMPLIED CONTRACT.
    10. I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL PROCESSING FEES.
    11. GIVEN THE PRESCRIBED NOTICE OFA CHANGE IN DUTY SCHEDULE, I WILL BE AVAILABLE TO WORK ANY SHIFT, (INCLUDING EVENING ASSIGNMENTS) DEEMED NECESSARY BY THE CORPORATION.
    12. ALL POSITIONS AND/OR SALARY LEVELS REQUIRE A BACKGROUND INVESTIGATION.
  2. I HEREBY AUTHORIZE THE PERSONS, SCHOOLS, CURRENT EMPLOYER, (IF APPROVED BY ME IN THE EMPLOYMENT EXPERIENCE SECTION) AND ANY OTHER ORGANIZATIONS OR EMPLOYERS NAMED IN THIS APPLICATION, TO PROVIDE OTB WITH ANY RELEVANT INFORMATION THAT MAY BE REQUIRED TO ARRIVE AT AN EMPLOYMENT DECISION.

By submitting this form electronically I certify that I have completely, accurately and truthfully answered all questions and understand all of the conditions set forth in this application.
(Do not send this form if you do not agree to the above statement)
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