EmailMe Form - HENDERSON MUNICIPAL POOL EMPLOYMENT APPLICATION

Today's Date

MM / DD / YYYY

Applicant Name *

First Last

Cell Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email (Please use an email that gets checked on a regular basis) *

Date of Birth *

MM / DD / YYYY

Position (check all that apply)

Lifeguard

Substitute

Education Level

High School

College/University

Other (please specify)

Current Certifications: (List Type and Expiration Date)

Lifeguard Certification
CPR/AED Certification
First Aid Certification
Other Relevant Certifications

Work Experience:

Previous Lifeguard Experience: (list previous lifeguarding jobs (if any), including the name of the facility, location, dates of employment, and any relevant details.

Other Relevant Work Experience:

List any other work experience that might be relevant to the lifeguard position (e.g., swim instructor, water safety instructor).

Pool hours are 1:00 pm to 8:00 pm. Guards are expected to arrive at 12:15 or 10:45 if you are an adult swim guard. Red Cross Lessons require more hours and begin at 8:45 am.

Availability:

How many days do you expect to work?

Days of the Week and Hours Available to Work

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Will you be available for Red Cross Lessons?

Yes

No

Will you be offering private lessons?

Yes

No

Skills and Qualifications:

Swimming Skills:
Lifesaving techiques you are proficient in (e.g. water rescues, swimming strokes)

Emergency Response:
Describe your experience in handling water-related emergencies.

Additional Information:

Use this space to provide any additional information that you believe is relevant to your application.

1 / 2

Su	Mo	Tu	We	Th	Fr	Sa
				1	2	3
4	5	6	7	8	9	10
11	12	13	14	15	16	17
18	19	20	21	22	23	24
25	26	27	28	29	30	31