Lansing Summer Rec Application Form 2026

City of Lansing - Summer Employment Application

Use this form to apply for lifeguard, pool manager, pool assistant manager, baseball head coach, baseball assistant coach, softball head coach, and softball assistant coach. If you have any questions, please contact Liz Jones, Deputy City Clerk, at deputyclerklansing52151@yahoo.com or call 563-538-4757. Applications are due by March 31st. You will be contacted by the Park and Rec Board for interview.
Applicant Information
Full Name

First NameMiddle NameLast Name
Birth Date - Must be at least 15 by June 1st, 2025

MonthDayYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Position Applying For
Available Start Date

MonthDayYear
END DATE: Summer Rec season ends on Labor Day. Please inform us of the date you are not longer able to work after (i.e. - you are headed back to college) if it is not Labor Day.

MonthDayYear
Are you a citizen of the United States?
If no, are you authorized to work in the United States?
Have you ever worked for the City of Lansing?
If yes, when and in what capacity?
Have you ever been convicted of a felony?
If yes, please explain:

Education
High School - Name of High School
Start Date: MM/DD/YYYY End Date: MM/DD/YYYY
Did you graduate?
College - Name of College
Start Date: MM/DD/YYYY End Date: MM/DD/YYYY
Did you graduate?
If yes, what degree?
Other - Name of Institution
Start Date: MM/DD/YYYY End Date: MM/DD/YYYY
Did you graduate?
If yes, what degree or training?

References

Please list at least two professional references
Reference 1
Full Name

First NameLast Name
Company
Address of Company

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email of reference
example@example.com
Phone Number of reference
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to reference
Reference 2
Full Name

First NameLast Name
Company
Address of Company

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email of reference
example@example.com
Phone Number of reference
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to reference
Reference 3
Full Name

First NameLast Name
Company
Address of Company

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email of reference
example@example.com
Phone Number of reference
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to reference

Previous Employment

Complete this section if you have had any previous employment, including with the City of Lansing.
Previous Employment 1
Company or Organization
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name

First NameLast Name
Supervisor Email
example@example.com
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job Title
Job Responsiblities
Start and end date of Employment
Start Date: MM/DD/YYY End Date: MM/DD/YYY
Starting and Ending Salary
Starting Salary: MM/DD/YYYMM/DD/YYY
Reason for Leaving
May we contact your previous supervisor for a reference?
Previous Employment 2
Company or Organization
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor Name

First NameLast Name
Supervisor Email
example@example.com
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Job Title
Job Responsiblities
Start and end date of Employment
Start Date: MM/DD/YYY End Date: MM/DD/YYY
Starting and Ending Salary
Starting Salary: MM/DD/YYYMM/DD/YYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Previous Employment 3
- Company or Organization
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Supervisor Name
  
  First NameLast Name
- Supervisor Email
  example@example.com
- Supervisor Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Job Title
- Job Responsiblities
- Start and end date of Employment
- Start Date: MM/DD/YYY End Date: MM/DD/YYY
- Starting and Ending Salary
- Starting Salary: MM/DD/YYYMM/DD/YYY
- Reason for Leaving
- May we contact your previous supervisor for a reference?

Additional Employment Screening
Please Acknowledge the Following:

All applicants 18 years of age or older who have not been previously employed by the City of Lansing are subject to a background check and drug test as a condition of employment with the City of Lansing.
I acknoweldge that I have read and understand the statement above.

Lifeguard Acknowledgment Statement
*For Lifeguard Applicants Only*

Please acknowledge the following:

All lifeguard hires are responsible for pruchasing their own swinsuit.

All lifegaurd employees must become certified as a lifeguard. There is a $200 refundable fee for the certifcation class. Refunds are based on 2 years of service at the pool and certification is valid for 2 years.
Please select one of the following:

Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview my result in my release.
Signature
Today's Date

MonthDayYear
Date
Should be Empty:

City of Lansing - Summer Employment Application

Applicant Information

Education

References

Reference 1

Reference 2

Reference 3

Previous Employment

Previous Employment 1

Start and end date of Employment

Starting and Ending Salary

Previous Employment 2

Start and end date of Employment

Starting and Ending Salary

Previous Employment 3

Start and end date of Employment

Starting and Ending Salary

Additional Employment Screening

Lifeguard Acknowledgment Statement

Disclaimer and Signature