Applicant Information
First Name: Last Name:
Address:
City: State:
Zip: Birth Date:
Home Phone: Cell Phone:
Social Security #: Driver's License #:
E-mail:
Desired Position:
If Other:
 
Employment History
Please list chronologically, beginning with most recent experience.
Employer: Address/City:
From (MM/YYYY): To (MM/YYYY):
Supervisor: Phone:
Salary:
Type of Work:
Reason for Leaving:
 
Employer: Address/City:
From (MM/YYYY): To (MM/YYYY):
Supervisor: Phone:
Salary:
Type of Work:
Reason for Leaving:
 
Employer: Address/City:
From (MM/YYYY): To (MM/YYYY):
Supervisor: Phone:
Salary:
Type of Work:
Reason for Leaving:
 
Education
Name & Location of School Select Last Year Completed Major Course Diploma/Degree
High School
College/University
Other
Business or Trade School
Certification Yes No Expiration Certification Yes No Expiration
Red Cross
Lifeguard Training		 CPR Certified
First Aid Certified AED Certified
WSI Certified Other
 
Personal Information
Are you legally authorized to work in the U.S.?:
Yes No
Are you at least 18 years of age?: Yes No
Do you have any special skills you wish to mention?:
Are you presently employed?: Yes No
If so, may we contact your present employer?: Yes No
If hired, when would you be available?:
If hired, when is the last day you would be available for work? (season ends one week after Labor Day):
 
Employment References
List individuals familiar with your job qualifications (No relatives or personal friends).
1) Name of Reference: 2) Name of Reference:
Occupation: Occupation:
Address: Address:
City/State/Zip: City/State/Zip:
Phone: Phone:
Relationship: Relationship:
How long known: How long known:
 
Please read carefully before submitting your application

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.

Check this box to certify that you have read and accept the above statement.