Required to Send Application (*)

NOTE: If you are running a firewall such as Norton, you must disable it to send this Application.

PERSONAL INFORMATION
*Your Full Name (As it appears on your Social Security Card): 
Prefer to be called by: 
*Address (summer): 
*City: *State: *Zip Code: 
*Phone: 
*Date of Birth: 
*Email Address: 

CERTIFICATIONS

*Are you certified? (Yes/No) 
Please specify the dates as well as the names of your instructor and the organization that certified you for the following:
- Lifeguarding?

- First Aid?

- Professional Rescuer (Adult, Child & Infant) CPR?

AVAILABILITY

*Position you are applying for (please check one):

- Gate Attendant
- Lifeguard
- Pool Manager
- Swim Lesson Instructor
- Service Technician
- Other
What major intersection are you close to: 
Do you have transportation to work? Yes / No 
Dates available to work?
Start 
Finish 

EDUCATION
High School: 
Grade Point Average: 
College: 
Grade Point Average: 
Major: 

Clubs, activities, sports, etc:
Awards, Honors, and Leadership Positions held:

WORK EXPERIENCE (List most recent job first. Please include any lifeguard experience you have)

First
Company Name:
Your Position:
Dates Worked:
Your Supervisor/Phone #: 
 

Your major job duties:

Second
Company Name:
Your Position:

Dates Worked:
Your Supervisor/Phone #: 
 

Your major job duties:

Third
Company Name:
Your Position: 

Dates Worked: 
Your Supervisor/Phone #: 
 

Your major job duties:

REFERENCES (List people other than family and peers. Use at least one teacher or coach)
Name: Profession: 
Phone #: 
Years Known: 
Name: Profession: 
Phone #: 
Years Known: 
Name: Profession: 
Phone #: 
Years Known:

MISCELLANEOUS INFORMATION
How did you hear about Kentuckiana Pool Management? 
Emergency Notification: Name 
Phone # 

You must check the box below in order to submit your application

I UNDERSTAND THAT MY EMPLOYMENT WILL BE STRICTLY SUMMER EMPLOYMENT, AND I WILL NOT FILE FOR UNEMPLOYMENT WHEN MY EMPLOYMENT ENDS.

NOTE: If you are running a firewall such as Norton, you must disable it to send this Application.

Kentuckiana Pool Management, Inc. is an Equal Opportunity Employer, offering employment without regard to race, color, religion, sex, national origin, age, sexual orientation, disability, citizenship or military/veteran status. We reserve the right to terminate any employee at any time for any reason pursuant to Kentucky law.