Little Swimmers Employment Application Employment Application Personal InformationName(Required) First Middle Last Position Applying for(Required)Swim InstructorAddress(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Drivers License #(Required) Drivers License State and Expiration(Required) Have you ever been convicted of a crime other than minor traffic violations?(Required) Yes No Please explain(Required) Certifications (check all that apply) CPR First Aid Lifeguard Emergency Contact(Required) Name Phone Number Relationship Languages spoken (check all that apply)(Required) English Spanish Other Specify Other Language(Required) Work ExperienceExperience working with children (check all that apply)(Required) Infants/Toddlers Two's/Three's Pre-school School Age No Experience Swim Experience (check all that apply)(Required) Swim Team Swim Instructor No Experience Other Specify(Required) If Swim Team, how many years or Other, please specifyWork Experience Related to Position Applying forCompany 1 Company From To Reason for Leaving Company 2 Company From To Reason for Leaving Company 3 Company From To Reason for Leaving Professional References (Minimurriof two)Reference #1(Required) Name Relationship Phone # Reference #2(Required) Name Relationship Phone # Reference #3 Name Relationship Phone # Physical Requirements (check all that apply)Are you able to lift 35 lbs.? {small children need to be lifted/assisted out of the pool) Yes No Are you able to move between pools quickly and safely? Yes No Are you able to see 25 feet with or without corrective lenses? Yes No Work AvailabilityWhat days and hours are you available to work?Monday Tuesday Wednesday Thursday Friday Saturday Have you ever applied for a position with Little Swimmers before? Yes No Give application date(Required) MM slash DD slash YYYY Application Signature(Required) I have read, understand, and agree to the above paragraph and attest the above information is true and accurate.Important Information- Please Read Carefully: No Guarantee of Employment. The applicant understands that completion of this application does not constitute as an employment contract or establish any term of employment. Little Swimmers has the right to elect refusal of application for any reason and not move forward in entering into an employment/employee contract. Application Date(Required) MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Δ
