|
Briarcliff Community Club
APPLICATION
FOR LIFEGUARD
Name:_______________________________________________________________________________________
Last
First MI
Nickname
Date of Birth:____/____/____Phone: (home)______________
(cell)_____________ Soc. Sec. # ___ - ___-______
Address:______________________________________________________________________________________
email
address:__________________________________________________________________________________
Parents/Guardians Names:
________________________________________________________________________
School attending and
Location_____________________________________ Current
Grade______________
Red Cross Certification (or equivalent) for Lifeguard Training, CPR,
and First Aid are required.
Check all that are currently certified and attach a copy of the
certificate.
Lifeguard Training ___,
CPR ___, First
Aid___, Water Safety Instructor___
If you are not currently certified, when will you be certified:
Lifeguard
Training:____/____/____ CPR:____/____/____ First
Aid:____/____/____ WSI:____/____/____
Work Experience (List LAST position FIRST)
Position Dates
Worked
Duties Supervisor
1____________________________________________________________________________________________
2____________________________________________________________________________________________
3____________________________________________________________________________________________
Job References (Local People Only Please)
1____________________________________________________________________________________________
Name
Relationship
Address
Phone
2____________________________________________________________________________________________
Name
Relationship
Address
Phone
When are you available to work?
Start:____/____/____ End:____/____/____
What Position are you applying for?
____Head Lifeguard ____Full Time
Guard (approximately 30-36 hrs/wk) ____Part Time
____Substitute Guard
If full/part time work is not available, would you like you name on
the substitute guard list?
____Yes ____No
________________________________________________________
Date: ____/____/____
Applicants Signature
Please return your completed application to:
Diane Alexander,
114 Dover Lane , Oak Ridge , TN 37830
Ph. #482-9911
email:
dianealex9911@yahoo.com |