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* 1. Position Interest

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* 2. Please provide your Personal Information below

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* 3. Certifications - Are you currently certified in the following?

  Yes No
Lifeguarding
First Aid
CPR - Professional Rescuer
Lifeguard Instructor - LGI
Water Safety Instructor - WSI

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* 4. Availability

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* 5. Education

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* 6. Most Recent Employment

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* 7. Second Most Recent Employment

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* 8. Reference #1

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