Derby Lane, and its subsidiaries are an equal opportunity employer and affords equal opportunity to all applicants for all positions they qualify for without regard to race, color, religion, gender, national origin, age, disability, genetics, veteran status or any other status protected under local, state or federal laws.

All the fields marked * are mandatory.




Mailing Address*

What position are you applying for?*

Cell Phone*

List any days/shifts/hours that you CANNOT work: or write Fully Available*

How did you hear about derby lane:

Because we are a gambling establishment and regulated by the State, many of our positions require a Pari-Mutuel License provided by the State of Florida, which requires fingerprinting and a background check. A License may be denied for some convictions disqualifying the applicant for the position.

Have you ever been employed by Derby Lane?

Have you had a pari-mutuel wagering license?

Are you over the age of 18?

Are you legally eligible to work in the United States? (Proof of eligibility will be required upon offer of employment)?

Have you ever been fired, or asked to resign from a job?

If yes, please explain

If you are applying for a position that requires driving: (i.e .. Valet, Outside Maintenance, Security) please answer the following questions:

Do you have a valid driver's license? Certain moving violations may disqualify you for certain positions.

Employment History

Company Name

Supervisor Name





Job Duties

Reason for Leaving

Please explain any gaps in your employment history

Additional Comments or Qualifications

Applicant Acknowledgement*

Download Blank Form