Name: *

First Name

Last Name

Phone: *

(###)

###

####

Birthdate: *

MM

DD

YYYY

Gender: *

Female

Male

What position are you applying for? *

Lifeguard

Manager

Office Staff

Camp Counselor

Camp Supervisor

Cleaning Staff

Dive Coach

Swim Coach

Swim Lesson Instructor

If applying for a position as a lifeguard, do you currently hold a lifeguard certification?

Yes

No

If you do currently hold a lifeguard certification, what is the expiration date?

MM

DD

YYYY

Applying for: *

Full Time

Part Time

Exact Date available to start work: *

MM

DD

YYYY

Approximate end of season work date: *

MM

DD

YYYY

By typing my name in this box, I acknowledge that the facts that are set forth in my digital application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. I give my permission for Pascack Valley Swim Club management to make any investigation of my personal history that I have provided. *

First Name

Last Name

Date of Application *

MM

DD

YYYY