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BVIA LIFEGUARD EMPLOYMENT APPLICATION

Please complete this application in it's entirety. INCOMPLETE or UNSIGNED applications will not be considered.
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, sex, age, national origin, marital status or disability.

First name*

Last name*

Email*

Phone*

Birthday*

Month

Day

Year

Education

High School*

Diploma

GED

Currently Enrolled

Other

Name of School*

Years Completed or Graduation Date*

College/University/Technical or Occupational School

Currently Enrolled

Associate Degree: 2 yr. degree

Bachelor's Degree: 4 yr. degree

Technical/Occupational (please include Certifcates, trade training, or specialized, accredited programs below.)

Other

Name of School

Years Completed or Graduation Date

Work Experience

List most recent work experience first.

Company Name

Company Address

Name of Supervisor

Job Title

Job Responsibilities

Start Date

Month

Day

Year

End Date

Month

Day

Year

Reason For Leaving

Work experience continued

Company Name

Company Address

Name of Supervisor

Job Title

Job Responsibilities

Start Date

Month

Day

Year

End Date

Month

Day

Year

Reason For Leaving

Lifeguard Certification Requirement

Do you have Lifeguarding/CPR/AED certification ? *

Yes

Other

Please list any additional certifications, trainings, etc. you have completed.

References

List your references, preferably (2) related to your work experience and (1) personal reference.

Work Reference 1: (Name, Address or Company Name & Phone Number)*

Work Reference 2: (Name, Address or Company Name & Phone Number)*

Personal Reference 3: (Name, Address or Company Name & Phone Number)*

Applicant Certification and Release

With my signature below, I certify that all information on this and all attached pages is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations.

I authorize all former employers to release job-related information they may have about me and I release all persons or companies from any liability or responsibility for providing such information.

Signature*

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Date of Signature*

Month

Day

Year

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