Renewal Application For A Compensated Casino Night Employee (Annually) Form - New Jersey Office Of The Attorney General Page 2

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B. Qualifications of Applicant
I am applying for an initial one-year license for:
Class "A" Operator - A class "A" operator must demonstrate at least three (3) years of experience
working at lawfully operated casino(s)/casino night(s), supervising or operating casino game(s) or
complete a course of study from a casino dealer school which includes instruction in the operation and conduct
of casino games. Please complete the section immediately below with your casino/casino
night employment history. If you have no previous casino/casino night employment history,
please fill out the section at the bottom of this page specifying your casino dealer
school information. Note: Only a class "A" operator may operate/supervise the games of roulette and craps.
Begin with the most recent employment.
Start
Name and Address
Qualified
Ending
Telephone
Title/Position Held
Date
of Employer
Game(s)
Date
number
Description of Duties
(For all applicants, if additional space is needed attach a notarized addendum to this application.)
Casino dealer school attended: _____________________________________ from: ____________ to: ____________
Address of casino school: _________________________________________________________________________
City
State ZIP code County
Street address
Telephone number: _________________________________ Contact person: ________________________________
(Include area code)
Course(s) successfully completed: ___________________________________________________________________
(Attach proof of all successfully completed courses.)

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