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Lifesaver Application
Lifesaver Application
Thank you for your interest in serving as a Lifesaver to the 2012 swimmers!
1.
Are you a new or returning Lifesaver?
New
Returning
2.
Why are you interested in being a Lifesaver?
3.
How many years have you participated in the Swim A Mile?
This will be my second year
3-5
6-10
11 or more
4.
Do you consider your strengths to lie more in:
Swim training
Fundraising
Both
5.
How often do you swim?
Not very often
A few times a month
More than once a week
6.
Where do you swim? (Please include city.)
7.
Can you commit to calling 20 swimmers to notify them when registration is open?
Yes
No
8.
Is there anything else you would like us to know?
9.
Please provide your contact information below.
Name:
Address:
City/Town:
State:
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Email Address:
Phone Number:
10.
I prefer to be contacted by:
Phone
Email
Either
Thank you! We will be in touch with you shortly. We expect to open registration in April. If you have any questions, you can reach Christine, our Swim A Mile coordinator, at swim@wcrc.org.