2026 Greenbrier Pool Employment Application
5103 Chesterfield Ave, SE., PO Box 4184, Charleston WV 25304
Check Box for Position Applying:
*
Lifeguard
Concession Stand
Name:
*
First Name
Last Name
Address:
*
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email:
*
example@example.com
Are you 18 or over? **If you are age 16 and under, you will need to provide a work permit.**
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Yes
No
Birthday:
-
Month
-
Day
Year
Date
Are you a member of Greenbrier Pool?
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Yes
No
This position is in Charleston, WV and requires in-person, on-site work. Please confirm you understand and are able to work at this location.
*
I understand and can work on-site in Charleston, WV
I cannot work on-site at this location
Previous Employment (most recent first):
Employer & Address:
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Job Description:
Dates Employed:
May we contact your previous employer?
Yes
No
Employer & Address:
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Job Description:
Dates Employed:
May we contact your previous employer?
Yes
No
References:
Reference Name:
*
First Name
Last Name
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship:
*
Reference Name:
First Name
Last Name
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship:
Availability:
Daily Availability (please mark all that apply):
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Date Available to START Employment:
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-
Month
-
Day
Year
Date
Please list ALL commitments (dates) that will alter your availablity to work. Examples: vacation, summer class, other employment, etc.
*
Last Day Available for Employment:
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-
Month
-
Day
Year
Date
Complete for Lifeguard Positions ONLY:
Lifeguard Certification:
*
Yes
No
Expiration Date:
Please enclose a copy of your lifeguard certification. **Must be current.**
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Red Cross Safety Certification:
*
Yes
No
Expiration Date:
Please enclose a copy of your Red Cross Safety certification. **Must be current.**
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CPR Certification:
*
Yes
No
Expiration Date:
Please enclose a copy of your CPR certification. **Must be current.**
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Do you have the following experience?
Prior Lifeguarding?
*
Yes
No
Explain:
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Chlorination?
*
Yes
No
Explain:
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Backwash?
*
Yes
No
Explain:
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Vacuuming?
*
Yes
No
Explain:
*
Complete for Concession Stand Positions ONLY:
Please enclose a copy of your Food Handlers Card/Certificate. **Must be current.**
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Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: