J-1 Lifeguard Training and Certification Program
Instructions: Before you start this application, ensure to the have the required documents listed on the J-1 Lifeguard Training and Certification Program website.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Age
*
Please select your category:
*
Full Time Post Secondary
Part Time Time Post Secondary
I am not a student
J-1 Program Details
Which J-1 Program are you applying for awhile completing your certification?
*
Summer Work and Travel
Camp Counselor
Not interested, only seeking Lifeguard Certification
Have you ever been on J1 Program previously?
*
Yes
No
If yes, can share the name of the program?
*
Emergency Contact 1
Name
*
First Name
Last Name
Relationship
*
e.g Parent, Sibling, Guardian
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Emergency Contact 2
Name
*
First Name
Last Name
Relationship
*
e.g Parent, Sibling, Guardian
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Upload Documents
Digital Passport Photo
*
Browse Files
Drag and drop files here
Choose a file
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of
Application Fee & Swimming Competency Test Payment Receipt
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
J-1 Lifeguard Training and Certification Program Terms and Conditions
*
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Choose a file
Cancel
of
Submit
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