Applicants must attach here a recently
taken passport type photograph.
It will not be returned.
Comhairle Contae Fhine Gall
Maor Snámha 2013
Fingal County Council
Beach Lifeguard Application 2013
The latest date for accepting completed applications is 4.30pm on Friday 1st March 2013.
Where copies of certificates etc are required please do not send original documents.
Misleading statements will render an applicant liable to disqualification.
1. Name in full (Block Letters) ______
2. Address (Block Letters) ______
______
3. Contact Number: ______
4. Date of Birth: ______Age:______
(Applicants must be at least 17 years old on 1st March 2013)
5. PPS No: ______
(If you have not been employed by Fingal County Council previously
please attach a copy of a letter of proof of your PPS number)
6. Email Address ______
7. Next of Kin (in case of emergency) Name: ______
Contact No.: ______
8. What is your current occupation: ______
9. If offered employment what date
would you be available to take up duty: ______
(Bathing Season commences Saturday 1st June 2013)
7. Education Details
DatesFrom To / Name of School / University / Examination / Results
8. Swimming / Life-Saving Qualifications (Please attach copies of relevant certificates)
Applicants are reminded that they must possess a valid Beach Lifeguard Award
Year of Award / Awarding Agency / Examination / ResultIf your qualification is due to be renewed please give Renewal Date: ______
9. First Aid / Basic Life Support Qualifications (including AED Training)
(Please attach copies of relevant certificates)
10. Other Qualifications (including Boat Competency, VHF Radio etc.)
(Please attach copies of relevant certificates)
DETAILS OF ANY OTHER QUALIFICATIONS SHOULD BE LISTED ON
1 ADDITIONAL PAGE SUBMITTED WITH THIS FORM
11. Does your health and fitness allow you to perform the duties of Beach Lifeguard:
Yes No
If No, please give brief details ______
______
12. Is your eyesight normal without contact lenses or glasses? Yes No
If No, state form of correction used ______
13. Is your colour vision normal? Yes No
If No, please give details of any problem______
14. List all of your previous employment or experience relating to swimming and/or life-saving in date order below:
From To
/Name and Address of Employer
/Type of Employment
15. Availability
Are you available: Full Time (up to 7days) OR Part-Time
AVAILABLE PREFERENCE
(a) Week-day Duty
(b) Week-end Duty
(Please tick the appropriate boxes)
Note: If available for both it is essential to express your preference
16. Declaration of authorisation in relation to certain posts involving work with Children:
Have you ever changed your surname? Yes No
Have you any criminal convictions: Yes No
If Yes, give details: ______
______
17. Garda Vetting - Signed Declaration:
(Applicants will be required to complete a Garda Vetting Form)
I hereby authorise An Garda Síochána to furnish Fingal County Council with a statement that there are no convictions recorded against me, or a statement of any convictions against me, as the case may be.
Applicant’s Signature: ______
18. REFERENCES: Give the names of two responsible people to whom you are well known, but not related, who may be contacted by Fingal County Council.
Name ______Name ______
Occupation ______Occupation______
Address ______Address ______
______
Tel No. ______Tel No. ______
I, the undersigned, hereby declare all the foregoing particulars to be true.
Signature of Applicant ______Date ______
Successful applicants may be required to perform duties of an auxiliary nature.
Note: The completed application should be returned to the
Operations Department (Lifeguards), Fingal County Council,
Civic Offices, Grove Road, Blanchardstown, Dublin 15
no later than 4.30pm on or before Friday 1st March 2013.