Employment Application For Lifeguards and Swim Instructors

Employment Application
Full Legal Name*

First NameM.I.Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Number*

Area CodePhone Number
Cell Number*

Area CodePhone Number
E-mail*
Drivers License Number*
Emergency Contact (Name / Phone Number):*
Position Desired*

LifeguardSwim Instructor
Schedule Availability*

Full TimePart Time
Are you 18 years of age or older:*

YesNo
I am a U.S. Citizen or am authorized to work in th U.S. on an unrestricted basis:*

YesNo
Have you ever been convicted, received deferred adjudication, or pled no contest to any criminal offense within the last 7 years or been released from prison for a crimal offense with the last 7 years?*

YesNo
If yes, please provide information regarding the nature of the offense and the court of recourse (a conviction will not necessarily ban you from consideration for employment):
Do you want to advise us on your starting salary expectations?*

YesNo
If yes, please provide salary expectations:

Swimming Experience:*

	Name of Swim Team	Name of Swim Coach	Years of Experience
Age-Group
High School
College

Swimming Awards:
Education

Education:*

	Name, City and State of School	Major	Did You Graduate?	Year
High School
College
Graduate School
Other Training

Other education:

Specialized Training:*

	Expiration Date
First Aid
Water Safety
CPR
Red Cross Lifeguard Cert

Employment History

(Please Submit Resume for additional employment information)
Current or Most Recent Employer Name:
If you are currently employed may we contact your present employer?

YesNo
Date Started Date Ended

Dates worked for
Most Recent Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Position Held:
Reason for Leaving:
Supervisors Name and Position:
Second Most Recent Employer
Second Most Recent Employer Name:
Date Started Date Ended

Dates worked for
Second Most Recent Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Position Held:
Reason for Leaving:
Supervisors Name and Position:
Third Most Recent Employer
Third Most Recent Employer Name:
Type a question

Date Started Date Ended

Dates worked for
Third Most Recent Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Position Held:
Reason for Leaving:
Supervisors Name and Position:
Please List 3 References

(Please Submit Resume for additional employment information)
Reference Name, Phone Number, and Relationship*
Reference Name, Phone Number, and Relationship*
Reference Name, Phone Number, and Relationship
At this point in the application you are free to tell us what makes you the perfect candidate for City of Plano Swimmers, if you desire.
Hobbies, interest? (not required )
Feel Free to upload your Resume:

Upload a File

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Thank you for taking time to complete this job application. We will be in contact with you shortly. We look forward to you potentially becoming part of the City of Plano Swimmers Inc. family.

Important (please read carefully): I certify that the information given by me to the City of Plano Swimmers Inc (COPS) is true and complete to the best of my knowledge. I understand that if I am employed, the discovery that I gave false information may result in my immediate dismissal. I authorize COPS to solicit information regarding my character, general reputation, credit and financial history, previous employment information from third parties (including a customer report from any investigative or credit agencies or bureaus of its choice) and to contact any and all references I have given on my application. I hereby release all parties and persons connected with such request for information from all liability and damages arising out of the furnishing of such information. If employed I release COPS from any liability for future references it may provide regarding my work history at the organization in consideration of my employment. I agree that my employment will be on an at will basis and that my employment can be terminated at any time with or without cause or notice at any time at the option of either COPS or myself.
Signature & Date:

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Should be Empty:

Employment Application

Education

Employment History

Second Most Recent Employer

Third Most Recent Employer

Please List 3 References