Life Guard Application

Full Name

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Address

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Phone

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Email

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Position Applying For

Are you a citizen of the United States?

If no, are you authorized to work in the U.S.

Are you a member of SARC

Are you on the Swim Team

Have you ever been convicted of a felony

If yes, explain

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High School Name and Address

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Did you graduate?

College Name and Address

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Did you graduate

Reference 1: Name, address, phone

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Are you Professional Rescuer Certified (life guard)

Date of Certification

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CPR Certification Date

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If not, when are you taking the class?

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Hours per week available to work

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Why are you applying for this job?

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Summer Camps or Sports Dates

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Family Vacation Dates if Known

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Other Summer Obligations

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Previous Employeer

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Responsibilities

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Reason for Leaving

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My we contact your previous supervisor for a reference?

Supervisor Name and Contact Information

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