Personal Information

Applicant Name

First Name

Last Name

Address

Email Address

Phone

(###)

###

####

Is the applicant a child of a current member?

Yes

Position Information

Available Start Date

YYYY

End Date

YYYY

Please describe any anticipated dates where you will be unavailable due to other commitments (school, vacations, sports, etc). Swim/dive/waterpolo staff must be available until conference meets end in mid July

School Information

High School

Current High School Grade or Year Graduated

College

Current College Year or Year Graduated

Work Experience

Position 1 - Employer Name

Position 1

Position 1 - Duties

Position 1 - Start Date

YYYY

Position 1 - End Date

YYYY

Position 2 - Employer Name

Position 2

Position 2 - Duties

Position 2 - Start Date

YYYY

Position 2 - End Date

YYYY

Other Skills/Training/Expeience

Life Guard & Swim Coaching Positions - Required Certifications

Lifesaving Certification Achieved

Yes

Lifesaving Date Completed or Expected

YYYY

CPR Certification Achieved

Yes

CPR Date Completed or Expected

YYYY

First Aid Certification Achieved

Yes

First Aid Date Completed or Expected

YYYY

Snack Bar Positions - Required Certifications

Food Handler License

Yes

Food Handler License Date Completed or Expected

YYYY

Applicant Agreement

Only current applications will be considered and it is possible that you will not be considered for employment. I authorize you to verify all information on this application. I certify that all of the information provided by me on this application is true and complete to the best of my knowledge. I understand that any false information, or omissions or misrepresentations of fact may be cause for refusal to hire or, if hired, for termination of employment. In consideration of my employment, I agree to conform to the rules and regulations of The LaGrange Field Club. I understand that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, at the option of either the Club or myself. I understand that no manager or representative of The LaGrange Field Club, other than the Personnel Chairperson of the Board of Governors has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. Any such agreement by the Personnel Chairperson of the Board of Governors must be in writing.

Applicant Signature

By signing below you accept all of the terms of the LaGrange Field Club application process, including the terms listed above.

Thank you for your application. The Personnel Chair will contact you regarding your application.

EMPLOYMENT Application