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Application Form

POSITION INFORMATION

Position applied for: *

How did you become aware of this vacancy? *

Which area are you located closest to? *

Please state the name and relation of any friends, acquaintances or relatives who are or have been employed to the Supreme Ventures Group.

PERSONAL INFORMATION

Name *

First

Middle

Last

Gender *

TRN *

NIS # *

Citizenship *

Place of Birth *

Address *

Address Line 1

City

State / Province / Region

Mobile Phone *

Landline

Email *

Date of Birth *

MM/DD/YYY

Have you ever been convicted of a criminal offense?

Do you or any of your friends or relatives currently operate a horse racing, sports betting or lottery terminal?

Has your employment ever been terminated?

EMERGENCY CONTACT INFORMATION

Name *

First

Last

Relationship *

Address *

Address Line 1

City

State / Province / Region

Phone *

PROFESSIONAL REFERENCES

LIST AS REFERENCES, 2 PERSONS OTHER THAN RELATIVES AND CLOSE PERSONAL FRIENDS.

Reference 1

Name *

First

Last

Address *

Address Line 1

City

State / Province / Region

Phone *

Occupation *

Relationship *

Reference 2

Name *

First

Last

Address *

Address Line 1

City

State / Province / Region

Phone *

Occupation *

Relationship *

Upload a photo of your ID

To complete your application, you are required to submit a copy of your Government Issued Photo ID (i.e. Driver’s License, Passport, Voters ID).

Submit Photo *

I certify that all the information given above is correct to the best of my knowledge and confirm that I understand the questions as stated above. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated.

Signature *

Date *

Supa Sellaz is a brand-new channel that is taking gaming to the streets, equipped with state of the art equipment that allows you to sell our popular products on the spot. This is a great new opportunity to start your own business and win your way by building it from the ground up – sell as much as you want! The more you sell the more you earn. Each Supa Sella will be linked to the participating Retailer or Supreme Ventures regional office in their area.