| First
Name
|
Last
Name
|
Date
of Birth (if under 21)
|
| |
| Position
Applying for
|
Social
Security #
optional |
|
| |
| Home
Address
|
City
|
State
|
Zip
|
| |
| College Address
(if you live there)
|
City
|
State
|
Zip
|
| |
| Home
Phone #
|
Alternative
Phone #
|
| |
|
|
| E-Mail Address
|
How often
do you check this address?
|
| |
| How
did you hear about Bi-State Pool Management
|
| |
| Education |
|
|
| |
|
|
| High
School:
|
Did you graduate?
Yes
No
Not Yet |
If
not yet, year in school
|
Grade
point average
|
| |
|
|
|
| College:
|
Did you graduate?
Yes
No
Not Yet |
If
not yet, year in school
|
Grade
point average
|
| |
|
|
| If
you are not a student, what is your occupation?
|
| |
|
|
| Do
you have swim experience?
Yes
No
If yes what
|
| |
|
|
| Which
of the following certifications do you have: |
Lifeguard
Training CPR-Professional
Rescuer
1st Aid
List any additional |
Yes
No
Yes
No
Yes
No
|
| |
| References |
| Please
give us the names of two persons you now well enough to recommend
you for the position. |
| |
|
|
| Name |
Phone |
How
do you know this person? |
| |
|
|
| |
|
|
| Name |
Phone |
How
do you know this person? |
|
|
|
| |
| Experience |
|
|
| Present or
most recent employer |
Phone |
Supervisors
Name |
|
|
|
| |
|
|
| Previous employer |
Phone |
Supervisors
Name |
|
|
|
|
| |
|
|
| May
we contact your employer(s)?
Yes
No
If no, why?
|
| |
|
|
| If
you are in school, when is your last day?
|
| |
|
|
| What
is the earliest date that you will be available to work?
|
| |
|
|
| If
you are in school, when do your classes begin in the fall?
|
| |
|
|
| What
will be your last possible working day for the summer?
|
|
|
|
| Do
you have any activities that may require special scheduling?
Yes
No |
| If
yes what are they?
|
|
| What
is a major intersection near your home?
|
|
|
|
| How
far would you be willing to drive one way?
|
|
|
|
| How
will you get to work?
|
|
|
|
| Do
you belong to a swimming pool?
Yes
No |
|
|
|
| Do
you have any physical limitations that may inhibit you from performing
any work for which you are being considered.
|
|
|
|
| If
so, what can be done to accommodate them?
|
| |
| Authorization |
| "I
certify that the facts contained in this application are true and
complete to the best of my knowledge and understand that, if employed,
falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all
statements contained herein and the references listed above give
you any and all information concerning my previous employment
and any pertinent information they may have, personal or otherwise,
and release all parties from all liability for any damage that
my result from furnishing them to you.
I understand and agree that, if hired,
my employment is seasonal and is for no definite period, and may,
regardless of the date of payment of my wages and salary, be terminated
at any time without any prior notice" |