Lifeguard Application 2017 Question Title * 1. Position Interest Gate Attendant Lifeguard Pool Manager Swim Lesson Instructor Service Technician Concession Attendant Other (please specify) Question Title * 2. Please provide your Personal Information below Full Name (As it appears in your Social Security Card): Prefer to be called by: Address (Summer): City / Town State / Province ZIP / Postal Code Email Phone Question Title * 3. Certifications - Are you currently certified in the following? Yes No Lifeguarding Lifeguarding Yes Lifeguarding No First Aid First Aid Yes First Aid No CPR - Professional Rescuer CPR - Professional Rescuer Yes CPR - Professional Rescuer No Lifeguard Instructor - LGI Lifeguard Instructor - LGI Yes Lifeguard Instructor - LGI No Water Safety Instructor - WSI Water Safety Instructor - WSI Yes Water Safety Instructor - WSI No Dates your Certifications Expire: Question Title * 4. Availability What major intersection do you live close to? Do you have transportation to work? (Yes or No) What is the date that you can start work? What will be your last day of work? Question Title * 5. Education Name of your High School: High School Graduation Year: Name of College or University: Major: Graduation (or Anticipated) Year: Clubs, Sports, Activities: Awards, Honors and Leadership Roles held: Question Title * 6. Most Recent Employment Company Name: Your Position: Dates Worked: Your Supervisor's Name: Supervisor's Phone Number Your Major Job Duties: Question Title * 7. Second Most Recent Employment Company Name: Your Position: Dates Worked: Your Supervisor's Name: Supervisor's Phone Number Your Major Job Duties: Question Title * 8. Reference #1 Name: Phone: Years Known: Question Title * 9. Reference #2 Name: Phone: Years Known: Question Title * 10. I understand that my employment will be strictly summer employment, and I will not file for unemployment when my employment ends. Yes No Done