Madison Aquatic Center
Employment Application
Applicant Info
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Email
*
Date Available
*
-
Month
-
Day
Year
Desired Salary
*
Position Applied For
Please Select
Lifeguard
Swim Instructor
Position(s) Applied For
*
Assistant Swim Coach
Lifeguard
Swim Instructor
Fitness Instructor
Personal Trainer
Front Desk Representative
Availability/Preferred Days & Times
Are you a citizen of the United States?
*
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
*
Yes
No
If so, when?
Have you ever been convicted of a felony?
*
Yes
No
If yes, explain
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Education
Education 1
School
Type of degree or diploma
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Attending?
Yes
Did you graduate?
Yes
Education 2
School
Type of degree or diploma
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Attending?
Yes
Did you graduate?
Yes
Education 3
School
Type of degree or diploma
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Attending?
Yes
Did you graduate?
Yes
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Previous Employment
Employment 1
Company
Phone Number
Format: (000) 000-0000.
Address
Supervisor
Responsibilities
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Work There?
Yes
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Employment 2
Company
Phone Number
Format: (000) 000-0000.
Address
Supervisor
Responsibilities
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Work There?
Yes
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Employment 3
Company
Phone Number
Format: (000) 000-0000.
Address
Supervisor
Responsibilities
From
-
Month
-
Day
Year
To
-
Month
-
Day
Year
Still Work There?
Yes
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
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References
Reference 1
Full Name
Relationship
Company
Phone Number
Format: (000) 000-0000.
Reference 2
Full Name
Relationship
Company
Phone Number
Format: (000) 000-0000.
Reference 3
Full Name
Relationship
Company
Phone Number
Format: (000) 000-0000.
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Sign
Signature
Submit Application
Submit Application
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