Instructor Intake Form
Instructor Name
*
First Name
Last Name
Preferred Name
If different from your legal name. This is the name that will go on our website. It is also the name your swimmers will call you.
Preferred Pronouns
Email address
*
example@example.com
Desired Start Date
/
Month
/
Day
Year
Date
Preferred Location(s) - Select all you'd like to work at.
South Philly
Center City
Creekside (summer only)
Schedule Availability
Are you willing to sub?
Please Select
Yes
No
Preferred age range of swimmers
Preferred ability level of swimmers
Are you comfortable working with clients with special needs?
Anything else we should know?
Submit
Should be Empty: