Lifeguard Application

Please fill out form and submit.

Position you are applying for

(please check one):

- Lifeguard
- Pool Manager
- Other

Personal Information

Your Full Name (As it appears on your Social Security Card):

Prefer to be called by:
Address (summer):
City: State: Zip Code:
Home Phone:
Cell Phone:

You must be over 15 years of age to enroll in a Lifeguard Certification Class.

Are you over 15 years old?

Email Address: (Required to send application)

Availability

Position Applying For:
What major intersection are you close to:
Do you have transportation to work? Yes / No
Dates available to work?
Start
Finish

School Experience

High School:
Grade Point Average:
College:
Grade Point Average:
Major:
What year will you be in next fall? (freshman, sophomore, etc):

Clubs, activities, sports, etc:
Awards, Honors, and Leadership Positions held:

WORK EXPERIENCE

(List most recent job first. Please include any lifeguard experience you have)

First
Company Name:
Your Position:
Dates Worked:
Your Supervisor/Phone #:

Your major job duties:

Second
Company Name:
Your Position:
Dates Worked:
Your Supervisor/Phone #:

Your major job duties:

Third
Company Name:
Your Position:
Dates Worked:
Your Supervisor/Phone #:

Your major job duties:

REFERENCES

(List people other than family and peers. Use at least one teacher or coach)
Name: Profession:
Phone #:
Years Known:
Name: Profession:
Phone #:
Years Known:
Name: Profession:
Phone #:
Years Known:

MISCELLANEOUS INFORMATION

How did you hear about Swim Atlanta Pool Management?
Emergency Notification: Name
Phone #