| Name: |
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| SSN# |
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| Birthdate |
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| Permanent Address |
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| Email Address |
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| Home Phone |
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| Cell Phone |
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| Emergency Contact Information (please include parent’s names if you are under 18) |
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| Position Applied for |
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| Desired Hours per Week |
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| Where in Atlanta would you prefer to work? |
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Have you ever worked for Sears Pool before?
If so, please tell us for how many summers and at what pool(s). |
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If not for SPMC, have you ever worked as a lifeguard before?
If so, please tell us where and for how long. |
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| What Certifications do you have? ( IF YOU ARE CERTIFIED YOU MUST SUBMIT A COPY OF YOUR LGT AND CPR CARDS) |
LGT:
CPRO:
Other:
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| When will you be able to work this summer? (we know schedules change, at this time we are only looking for an approximate start and finish date) |
Start date:
Finish date:
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INTERNATIONAL STUDENTS ONLY
Have you ever worked in the US before? If yes, please tell us where, in what position, and how (name of agency and type of visa). Please give us a permanent address and phone number that we can contact you for a phone interview and reach you after the summer is over (parent’s house, for example). |
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