Fayette Area Swim Team
Job Application
Instructions: Please fill out all sections of this application completely.
Date________________________________
Name_________________________________________________________________
Last First Middle
Address________________________________________________________________
Street No. or P.O. Box City Zip Code
Email Address___________________________________________________________
Telephone Numbers_______________________________________________________
Home Cell
Social Security Number______ /_____ /_______ Date of Birth /_____ /_____
Education: Circle Highest Grade Completed: 7 8 9 10 11 12
College: Circle Number of Years Completed: 1 2 3 4
Degrees Held:___________________________________________________________
Special Training/Certification
Life Guarding ____________________________ Expiration Date_____________
Standard First Aid_________________________ Expiration Date_____________
CPR___________________________________ Expiration Date_____________
Water Safety Instructor_____________________ Expiration Date_____________
Competitive Swimming Experience:___________________________________________
Previous Work Experience: List below, beginning with most recent employment.
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Title/Description of Duties
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Start/End Dates
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Employer Name & Address
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Employer Name & Address
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Fayette Area Swim Team
Job Application
page 2
Emergency Contact___________________________________________________
Name Relationship
Address:___________________________________________________________
Street No. or P.O. Box City Zip Code
Phone Numbers_____________________________________________________
Home Cell
I certify that to the best of my knowledge and belief, the information given, truly represents my background and experience. I understand that if I have knowingly misrepresented, falsified, or omitted any of the application information, I may be disqualified for employment consideration or dismissed from employment with Fayette Area Swim Team.
I hereby authorize any and all school, former employers, references, courts and any others who have information about me, to provide such information to Fayette Area Swim Team, and I relieve all parties involved from any and all liability for and any and all damage that may result from providing such information.
I understand that if offered a position with Fayette Area Swim Team, I may be required to submit a pre-employment medical examination, drug screen, and background check as a condition of my employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employment tests and checks will result in withdrawal of any employment offer or termination of employment, if already employed.
By signing below, I acknowledge that I have read, understood and agree to the above.
________________________________________________________________________ ________________
Signature of Applicant Date
________________________________________________________________________ ______________________
Signature of Parent or Guardian Date
________________________________________________________________________ ______________________
Signature of Parent or Guardian Date