Doyle Street Pool Summer Staff Application

List any of your current certifications and their expiration dates. This includes First Aid, CPR, AED, Lifeguarding, and/or WSI. You must hold the proper certification for the job for which you are applying. Copies of these certifications must be presented prior to assuming your duties. Courses may be available for you, should you need to recertify.*
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References:
REFERENCES: List three (3) persons NOT related to you who can judge your qualifications for this position.
Reference Name:*
Reference Phone Number:*

Area CodePhone Number
Reference E-mail:*
Reference Position Title:*
How long have you known this reference?*
What is your relationship with this person?*
Reference Name*
Reference Phone Number:*

Area CodePhone Number
Reference E-mail:*
Reference Position Title:*
How long have you known this reference?*
What is your relationship with this person?*
Reference Name*
Reference Phone Number:*

Area CodePhone Number
Reference E-mail:*
Reference Position Title:*
How long have you known this reference?*
What is your relationship with this person?*

Submission:
I understand that a successful completion of a physical examination and current immunizations are conditions of employment.*

YesNo
I understand that employment is contingent upon passing a criminal background check and drug test and I give Camp Fire Georgia permission to conduct a check at the time I am offered a position, but prior to being officially hired.*

YesNo
I certify that all information provided is true and complete. I understand that falsification or significant omission of any information may be considered justifications for dismissal if discovered at a later date.*

YesNo
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Camp Fire Georgia is an Equal Opportunity Employer. The Council does not discriminate on the basis of race, color, sex, age, disability, religious affiliation, national origin, citizenship or sexual orientation.
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