Employment Application Application for Employment If you have any questions about the application, or would prefer it emailed to you in PDF format please email jobs@shorebeach.com Starting Date of Availability : Ending Date of Availability : Name : * Height : Weight : Sex : Select Female Male Date of Birth : * US Social Security # : Driver's License # : * State : * Expiration : * Phone Number : * Email * Mailing Address : * City : * State : * Zip : * Lifeguarding, CPR and First Aid certifications are required prior to employment as a lifeguard. Please list those currently held below and send copies. If not currently ceritfied, give approximate date of course completion. Lifeguarding Certifying Agency : * Expiration Date : * CPR Certifying Agency : * Expiration Date : * Evidence of a sports physical received within the last year is required prior to employment as a lifeguard. Date of physical. Please send in with application if possible. You can submit application without a physical, but one is required before employment begins : * Have you received Hepatitis B vaccinations? Vaccination is not required for employment : * Yes No List any other certifications or training you may have that would be applicable to this job : Do you have any physical impairments/conditions that could limit your job performance? : * Yes No If yes, explain : Do you regularly take any medications? : * Yes No If yes, explain : Have you ever been convicted of driving under the influence of drugs or alcohol? : * Yes No If yes, explain : Do you have housing for the summer? : * Yes No Will you have a vehicle for the summer? * Yes No Education High School : * Grade Level Completed : * College : Grade Level Completed : List work history including part-time jobs and volunteer work. Employer 1 Name of Organization : Dates of Employment : Phone : City : State : Starting Salary : Ending Salary : Reason for Leaving : Supervisor's Name : Description of Duties : Employer 2 Name of Organization : Dates of Employment : Phone : City : State : Starting Salary : Ending Salary : Reason for Leaving : Supervisor's Name : Description of Duties : References Name : Relationship : Phone : Email : Name : Relationship : Phone : Email : Name : Relationship : Phone : Email : Write a brief summary about the abilities and attributes you can offer Shore Beach Service : * How did you hear about Shore Beach Service : * Upload files (physical forms, certifications etc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) Upload file button The maximum file size is 5mb (jpg, jpeg, png, pdf, doc) I, the undersigned, do certify that I have truthfully answered all questions on this application to the best of my ability. Signature of Applicant : * Date :