Current or Most Recent Employer: Dates of Employment: Position Held: Employer Name & Address: Starting Rate of Pay: Full time Part-time Ending Rate of Pay: If part-time, # hrs./wk: Supervisor Name, Title & Contact Number: May we contact this employer? Reason for Leaving: Yes No Primary Duties & Responsibilities: Name employed if different than above: Previous Employer: Dates of Employment: Position Held: Employer Name & Address: Starting Rate of Pay: Full time Part-time Ending Rate of Pay: If part-time, # hrs./wk: Supervisor Name, Title & Contact Number: May we contact this employer? Reason for Leaving: Yes No Primary Duties & Responsibilities: Name while employed if different than above: Previous Employer: Dates of Employment: Position Held: Employer Name & Address: Starting Rate of Pay: Full time Part-time Ending Rate of Pay: If part-time, # hrs./wk: Supervisor Name, Title & Contact Number: May we contact this employer? Reason for Leaving: Yes No Primary Duties & Responsibilities: Name while employed if different than above: Aquatic Certifications (Please check all that apply) American Red Cross Lifeguarding/First Aid/CPR/AED certification Date Completed:__________ Expiration Date:__________
Current or Most Recent Employer: Dates of Employment: Employer Name & Address: Position Held: Starting Rate of Pay: Full time Part-time If part-time, # hrs./wk: Ending Rate of Pay: Supervisor Name, Title & Contact Number: May we contact this employer? Yes No Reason for Leaving: Primary Duties & Responsibilities: Name employed if different than above: Previous Employer: Dates of Employment: Employer Name & Address: Position Held: Starting Rate of Pay: Full time Part-time If part-time, # hrs./wk: Ending Rate of Pay: Supervisor Name, Title & Contact Number: May we contact this employer? Yes No Reason for Leaving: Primary Duties & Responsibilities: Name while employed if different than above: Previous Employer: Dates of Employment: Employer Name & Address: Position Held: Starting Rate of Pay: Full time Part-time If part-time, # hrs./wk: Ending Rate of Pay: Supervisor Name, Title & Contact Number: May we contact this employer? Yes No Reason for Leaving: Primary Duties & Responsibilities: Name while employed if different than above: Aquatic Certifications (Please check all that apply) American Red Cross Lifeguarding/First Aid/CPR/AED certification Date Completed:__________ Expiration Date:__________
Triangle-App-for-Employment.docx