AQUATECH MANAGEMENT OF LONG ISLAND, INC.
EMPLOYMENT APPLICATION 2017
NAME______
Last First MI
ADDRESS______
Street City State Zip
HOME PHONE ( )______DATE OF BIRTH ___/___/______
CELL PHONE ( ) ______SOC.SEC. #______-______-______
Email Address ______
CURRENT CERTIFICATIONS DATE RECEIVED DATE EXPIRES
American Red Cross Lifeguard Training Yes/No ______
Nassau County Pool Certification Yes/No ______
Nassau County Bay/Beach Certification Yes/No ______
CPR Certification (DOH accepts first year only) Yes/No ______
Other Certifications (WSI, etc.) Yes/No ______
(Attach a copy of all your certifications; this application will not be processed without the proper certifications)
Days/Hours Available – All Lifeguards are required to be available on Weekends/Holidays
Monday____ Hours Available: from ______to ______
Tuesday____ Hours Available: from ______to ______
Wednesday____ Hours Available: from ______to ______
Thursday____ Hours Available: from ______to ______
Friday____ Hours Available: from ______to ______
Saturday / Sunday we require our lifeguards to be available on weekends
What date are you available to start work? ______
Will you be away for any length of time this summer? Dates? ______
______
EMPLOYMENT HISTORY:
Present Or Last Position:
Employer: ______
Address:______
Supervisor:______
Phone: ______Email:______
Position Title: ______From: ______To: ______
Responsibilities:______
______
Salary: ______
Reason for Leaving:
______
May We Contact Your Present Employer? Yes _____ No _____
Three References:
Name, Title, Address, Phone
1-______
2-______
3-______
University or High School you will be attending in the fall of 2017:
______
IF HIRED BY AQUATECH MANAGEMENT OF LONG ISLAND, INC. YOU WILL BE ASKED TO WORK UNTIL LABOR DAY. IF THIS IS NOT POSSIBLE DUE TO COLLEGE COMMITMENTS PLEASE INDICATE WHEN YOU ARE EXPECTED BACK ON CAMPUS.
*DATE YOU ARE DUE BACK ON CAMPUS ______.
*YOU WILL BE EXPECTED TO WORK UNTIL TWO DAYS BEFORE YOU ARE DUE BACK ON CAMPUS.
I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
Signature______
Date______