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Lifeguard Online Employment Application

First and Last Name;

Email Address:

Address:

Address 2:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Social Security #:

Date of Birth:

How were you refered?:

Refered by: (Person Name or School Name):

Previous Lifeguard Work Experience:

Employment From ( If no work experience skip to next question):

Employment to ( If no work experience skip to next question):

Brief Job Description (If no work experience please type in N/A):

Do you have transportation?:

Available for:

Date Available to Start:

Date Available to Work Until:

Certification

Lifeguard Training:

Lifeguard Training - Date Issued:

Lifeguard Training - Expires:

CPR/AED for the Professional Rescuer Issue Date:

CPR/AED - Expires:

If you have Certification please upload here:

Education

High School/College Name:

Current Grade/Year:

Comments: (IE;What days will you be UNAVAILABLE to work? (Vacation, other job, etc.)