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Returning Lifeguard Application
This application will be kept on file at the Harvey Cedars Police Department for two years from the date of application. This application does not guarantee employment.
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* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
*
Your answer
Middle Name
Your answer
PERMANENT ADDRESS (Street, City, State, ZIP)
*
Your answer
Home Phone Number
Your answer
Cell Phone Number
*
Your answer
Driver's License Number
*
Your answer
Driver's License State
*
Your answer
Social Security Number
*
Your answer
Date Of Birth
*
MM
/
DD
/
YYYY
Age as of 05/31/2024
*
Your answer
Are you:
*
Single
Married
Seperated
Divorced
Widow
Widower
Other:
Are you a U.S. Citizen?
*
Yes
No
Have you ever been convicted of a felony or misdemeanor within the last 5 years?
*
Yes
No
If YES, please describe
Your answer
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