2023 Seasonal Employment Application - Summer Playground
Please complete this application to be consider for a position with the Pottsgrove Recreation Summer Playground Program. 2023 Summer Playground runs June 20-July 21 Monday-Thursday at Lower Pottsgrove Elementary School and Fridays at the North End Pool. There is no Playground on July 4 or on Fridays when it rains. School Days are from 8:45-12:15 for staff and pool days are 9:45-12:15at North End Pool. Not all staff will be needed on Pool Days so you may have Fridays off.
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Please provide if under 18.
Social Security Number
Email
example@example.com
Position(s) applying for
Leader - 18+
Counselor - 16+
Jr. Counselor - 15+
Counselor in Training - 14+
Weeks Available to Work:
June 20 - 23, 2023
June 26 - 30, 2023
July 3 - 7, 2023 (No Playground July 4)
July 10 - 14, 2023
July 17 - 21, 2023
Please explain any weeks/days you will not be available.
Please indicate t-shirt size
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Education Information
High School
Current Year/Graduation Year
High School City/State
College/University
Current Year/Graduation Year
College/University City/State
Concentration/Major
Post Graduate Education
Current Year/ Graduation Year
Concentration/Major
Skills & Training
Please list all applicable skills and training for applicable job. (babysitting, community service, school clubs, sports, computer skills, etc.
Employment
Company Name
Position
Supervisor's Name
Supervisor's Phone Number
Please enter a valid phone number.
Work Dates
Duties Performed
Company Name
Position
Supervisor's Name
Supervisor's Phone Number
Please enter a valid phone number.
Work Dates
Duties Performed
References
Reference Name
Reference Phone Number
Please enter a valid phone number.
Relationship
Company/School
Reference Name
Reference Phone Number
Please enter a valid phone number.
Relationship
Company/School
Emergency Contact
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Phone Number
Please enter a valid phone number.
Relationship
Allergies or Important Medical Information
Please provide any information you feel we need to know to help in the event of an emergency.
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