2025 Greenbrier Pool Employment Application
5103 Chesterfield Ave, SE., PO Box 4184, Charleston WV 25304
Check Box for Position Applying:
*
Manager
Lifeguard
Concession Stand
Name:
*
First Name
Last Name
Address:
*
Phone Number:
*
Please enter a valid phone number.
Email:
*
example@example.com
Are you 18 or over? **If you are age 16 and under, you will need to provide a work permit.**
*
Yes
No
Birthday:
-
Month
-
Day
Year
Date
Are you a member of Greenbrier Pool?
*
Yes
No
Previous Employment (most recent first):
Employer & Address:
Phone Number:
Please enter a valid phone number.
Job Description:
Dates Employed:
May we contact your previous employer?
Yes
No
Employer & Address:
Phone Number:
Please enter a valid phone number.
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.
Relationship:
*
Reference Name:
First Name
Last Name
Phone Number:
Please enter a valid phone number.
Relationship:
Availability:
Daily Availability (please mark all that apply):
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Date Available to START Employment:
*
-
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:
*
-
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:
*
Chlorination?
*
Yes
No
Explain:
*
Backwash?
*
Yes
No
Explain:
*
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: