Rio Vista Sharks Staff Application
Simonsen Delta Swim Center • 300 California Street • Rio Vista CA 94571
Name
Social Security #
Birth Date Age
Grade
Sex
Cell phone
Email
Permanent Address
College address (if applicable)
Position • Check all positions in which you are interested
___Asst. Pool Mgr F/T Lifeguard ___P/T Lifeguard ___Sub Lifeguard
__Instructor ___Swim Coach ___Junior Coach
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Completion Date |
Expiration Date |
Agency or Chapter |
| Water Safety Instructor |
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| Lifeguard Instructor |
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| Lifeguard Training |
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| Basic Lifeguarding |
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| Standard First Aid |
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| DCPR |
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Copies of all certifications must be submitted with your application.
Availability • List Days/Dates that you are unavailable to work
Work History • Use the back of the form or an additional page if needed
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Address & Phone number |
Beginning/End Dates |
Position |
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References
Name Phone
Name Phone
Email application to: [email protected] or drop it off at
