2021 Lifeguard Application
Melonie Park South
First & Last Name *
Address *
Phone Number *
High School *
University, Higher Education, or Trade School (if applicable)
I am applying for the following position: *
Work Experience *
List previous lifeguard, pool management or swim lesson experience, if any:
Red Cross Life Saving Certificates: Check all that apply
List the year certified and date expired for each certification you have:
Tell us about yourself and list any extracurricular activities you participate in: *
List 3 References (over the age of 18) other than relatives. Please include Name, email address & phone number) *
Are you currently taking any medication or have any health concerns? If yes, please explain. *
Emergency contacts: list two closest relatives including name and phone number: *
What days are you available to work? *
What hours are you available to work on each day checked in previous question? *
Would you be willing to teach swim lessons Wednesday-Saturday from 10:00am-11:00am?
Would you be able to work weekdays and weekends until school begins in August? *
Would you be able to work weekends and possibly after school once school begins in August until Labor Day?
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