Lighthouse Pool Management, Inc. | Application

Last Name

Middle Initial

First Name

Social Security Number #

Date of Birth mm/dd/yyyy

HOME ADDRESS:

Apt#

City

State

Zip Code

Home Telephone (including area code)

Cell Phone (including area code)

E-mail

*************************************************************************************

Positions Desired

Pool Desired:

Will you be available? Full-time Part-time Substitute

Are you involved in any activities that may conflict with a full-time schedule? Yes No

If yes, please explain.

Will you be available to work full-time beginning Memorial Day weekend? Yes No

Will you be available to work through Labor Day? Yes No

If no, when will be your last day? (If known)

Do you have any vacations planned? Yes No

If yes, please give dates of unavailability (If know.)

EDUCATION:

Name of High School

Location

Graduation Date mm/yyyy

Name of College/University

Location

Graduation Date mm/yyyy

**************************************************************************************

CERTIFICATES:

Are you a Red Cross (or other A.L.A approved certified lifeguard?
Yes No

If yes, please list the date your certification expires. mm/dd/yyyy

If you possess a valid certification of the following, please check and list expiration date (If you need any of the following certifications please check the corresponding box.)

**************************************************************************************

PREVIOUS WORK/SWIMMING POOL EXPERIENCE:

Company

Position

Dates mm/yyyy - mm/yyyy

Pay Rate $

Company

Position

Dates mm/yyyy - mm/yyyy

Pay Rate $

Company

Position

Dates mm/yyyy - mm/yyyy

Pay Rate $

Company

Position

Dates mm/yyyy - mm/yyyy

Pay Rate $

EMERGENCY INFORMATION

In Case of an emergency, please notify

Telephone (including area code)

Can you perform the essential functions of this job with or without reasonable accommodations? Yes No

What, if any, accommodations are required?

Are you legally authorized to work in the United States ? Yes No

Have you ever been convicted of a felony? Yes No

If yes, please explain:

**************************************************************************************

“Lighthouse Pool Management Inc. is an equal opportunity employer. Our policy is to adhere to all applicable laws that prohibit discrimination in employment.”

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above may give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from any liability for any damage that may result from furnishing the same to you.”

“I understand and agree that, if hired, my employment is at will for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.”

“Should I become injured on the job and file a claim under Workman's Compensation, I authorize any past or present treating doctor or hospital to release medical information requested by my employer or their insurance carrier for the purpose of processing my claim. A photocopy of this authorization shall be as valid as the original.”

A lifeguard is legally responsible for the safety of pool patrons. Lifeguards must enforce and adhere to pool rules and regulations. To be a professional lifeguard, a person must be physically fit, able to remain alert, sit for long periods of time, and be quick to respond to an emergency. A lifeguard's physical fitness includes hearing, sight, strength, and endurance, which are all vital to a rescue. A lifeguard must be certified in lifeguard training, first aid, and CPR in addition to being physically fit. Lifeguards must be able to make sound decisions, communicate verbally, and hear sounds of distress. Lifeguards must possess a positive attitude and be able to cooperate with other guards. Individuals with physical or mental conditions may not be qualified for the job of the professional lifeguard, even though they may be certified as a lifeguard.

“UNDER VIRGINIA , MARYLAND AND NORTH CAROLINA LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.”

“I UNDERSTAND THE DEMANDS OF LIFEGUARDING AND AM ABLE TO PERFORM THE NECESSARY DUTIES OF A PROFESSIONAL LIFEGUARD.”