First, please select a location:

Personal Information

First Name:
Middle Name:
Last Name:
Today's Date:

Home Address:
City:
State:
Zip:

Home Phone:
Alternate Phone:
Email:

Are you under the age of 18?  Yes No
If yes, please state your date of birth:

Position Desired:
Pay Desired:
Referred By:

Date you can start:
 Full Time Part Time Summer Only

Vacation Dates:

Dates & Hours Available
Mon
From:
To:
Tue
From:
To:
Wed
From:
To:
Thu
From:
To:
Fri
From:
To:
Sat
From:
To:
Sun
From:
To:

Have you ever been convicted? (Include all pleas of “no contest” and/or “guilty”, excluding traffic violations)  Yes No

If yes, give details: (a conviction will not necessarily disqualify an applicant)

Are you physically able to perform the skills necessary to complete the duties of the job for which you are applying?  Yes No

If no, explain:

Have you ever been fired from a job or asked to resign?
 Yes No

If yes, explain:

Employment History

List employment with the most recent position. Account for any time during this period that you were unemployed by stating the nature of your activities.

May we contact your current employer?  Yes No
May we contact your past employer?  Yes No

Employer 1

Employer Name
From Date:
To Date:
Phone:

Address:
City:
State:
Zip:

Your job title:

Duties:

Start Salary/Wages
End Salary/Wages
Supervisor Name

Employer 2

Employer Name
From Date:
To Date:
Phone:

Address:
City:
State:
Zip:

Your job title:

Duties:

Start Salary/Wages
End Salary/Wages
Supervisor Name

Employer 3

Employer Name
From Date:
To Date:
Phone:

Address:
City:
State:
Zip:

Your job title:

Duties:

Start Salary/Wages
End Salary/Wages
Supervisor Name

Education

Type of School
Name and Location of School
Degree/Area of Study
Number of Years Attended
Graduated?

High School
 Yes No

College
 Yes No

Graduate School
 Yes No

Other
 Yes No

Special Activities/Certifications

Which of the following certifications do you have:
 Life Guard
Date on card:
 WSI
Date on card:

 CPR
Date on card:
 First Aid
Date on card:

 Other
Other specialty/certification:
Date on card:

 Other
Other specialty/certification:
Date on card:

Honors Received/ Athletic Achievements/ School Clubs

Please list any athletic, academic, or civic activities which may be appropriate to the position you are applying: (exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age disability or other protected status)

Professional References (May not list relatives)

Name
Address
Years Known
Title
Work #

Attach Resume (Optional PDF, DOC or DOCX)

I understand and agree that Aqua-Tots shall administer background checks on new employees having sensitive positions including but not limited to those positions which (1) handle cash and credit card information; (2) are responsible for facility security (3) have occasion to be alone with children. I understand and agree that employment is conditional upon the results of these checks. I certify that all information provided in this Application for Employment is true, correct and complete. I understand that any false or misleading information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any and all statements contained in this application.


I UNDERSTAND THAT NEITHER THIS APPLICATION NOR VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESSED OR IMPLIED CONTRACT OF EMPLOYMENT OR GUARANTEE OF EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME AND THAT ANY SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE DULY AUTHORIZED REPRESENTATIVE OF THE EMPLOYER AND THE EMPLOYEE, IF EMPLOYED.


I hereby release and hold Aqua-Tots from any and all claims whatsoever, including but not limited to personal injury, arising out of or relating to any non-work hour and/or non-work related recreational activity provided to employee by or on behalf of Aqua-Tots. I further understand and agree that if employed, the employment will be "at will,” which means that the employee or Aqua-Tots, may end the employment relationship at any time, for any reason, or for no reason.


I have read, understand and consent to these statements.
 Yes