New 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.
Email address *
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
Place of Birth (City, State, County) *
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Age as of 07/31/2018 *
Your answer
Height *
Your answer
Weight *
Your answer
Eye Color *
Your answer
Hair Color *
Your answer
Are you: *
Are you a U.S. Citizen? *
Have you ever been convicted of a felony or misdemeanor within the last 5 years? *
If YES, please describe
Your answer
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