Full Name Best time of day to call: Morning Afternoon Evening

Home Phone Work Phone Cell Phone

Address

City State Zip Code

Email Confirm Email


Were you referred to American Swim Academy?
Yes No If yes, by whom?

Have you ever been employed by ASA?
Yes No If yes, when?

If you are under 16 years of age, can you provide a work permit?
Yes No If no, please explain

Are you authorized to work in the USA? (Proof of eligibility may be requested if hired)
Yes No

Have you ever pled guilty, no contest, or been convicted of a crime?
(A conviction will not necessarily disqualify you from employment.)
Yes No If yes, please explain:
Are you fluent in any languages other than English?
Yes No If yes, please list

Do you currently possess any of the following certifications? (Check all that apply)
CPR (Adult/Chid/Infant) Date on card:
Lifeguard Date on card:
First Aid Date on card:
WSI or WSA Date on card:

When are you available to start work?

How many hours can you work per week?

Indicate the days and hours you are available:
No pref Mon
 Tues
 Wed
 Thurs
 Fri
 Sat
 Sun

EDUCATION

NAME OF SCHOOL LOCATION YEARS COMPLETED MAJOR/DEGREE ACHIEVED
HIGH SCHOOL
COLLEGE
SKILL OR
TRADE SCHOOL

WORK EXPERIENCE

Employer Dates Employed: From To

Address Phone

Your Title Your Immediate Supervisor's Name & Title

Nature of Work & Responsibilities

Reason for Leaving



Employer Dates Employed: From To

Address Phone

Your Title Your Immediate Supervisor's Name & Title

Nature of Work & Responsibilities

Reason for Leaving



Employer Dates Employed: From To

Address Phone

Your Title Your Immediate Supervisor's Name & Title

Nature of Work & Responsibilities

Reason for Leaving

PERSONAL REFERENCES (Name three people, not relatated to you, whom we may contact)

Name Relation Years Acquainted Phone
Name Relation Years Acquainted Phone
Name Relation Years Acquainted Phone




INFANTS & TODDLERS   PRE-SCHOOLERS   BEGINNING SWIMMERS   INTERMEDIATE & ADVANCED SWIMMERS   YOUNG ADULTS   ADULTS

HOME   PRE-REGISTER   NEWS & EVENTS   FAQS   ABOUT US   EMPLOYMENT   CPR & SAFETY TRAINING   CONTACT US
DUBLIN LOCATION     FREMONT LOCATION     LIVERMORE LOCATION     NEWARK LOCATION