Employment Application
16 Stenersen Lane, Suite 4A Hunt Valley, MD 21030 Phone: 410-785-7665 . 800-466-7665 Fax: 410-785-2520
GENERAL INFORMATION
State:
State:
Are you authorized to work in the U.S.?
AVAILABILITY
Do you want to work full-time or part-time? Full-time (30-40hr) Part-time (20-30hr)
If your school year ends after Memorial Day, are you available to work?
If you are not a student, what is your current occupation?
If you are a student, do you play a fall sport?
Can you work through Labor Day?
For your regular pool assignment, how far are you willing to drive? Up to
How do you plan to get to work?
Have you ever been dismissed from employment for any reason other than lack of work?
HOW DID YOU HEAR ABOUT DRD POOLS?
Worked for DRD Previously
New DRD Applicant Only
EDUCATION
Name
GPA
Year of Graduation
High School
Name
GPA
Year of Graduation
College
Name
GPA
Year of Graduation
TRAINING
Year Training Course Was Passed
Expiration Date of License or Certificate
Where did you take the training course?
Starguard Lifeguard Training
Year Training Course Was Passed
Expiration Date of License or Certificate
Where did you take the training course?
RED CROSS Lifeguard Training
Year Training Course Was Passed
Expiration Date of License or Certificate
Where did you take the training course?
YMCA Lifeguard Training
Year Training Course Was Passed
Expiration Date of License or Certificate
Where did you take the training course?
Swimming Pool Operator License
Year Training Course Was Passed
Expiration Date of License or Certificate
Where did you take the training course?
PREVIOUS EMPLOYMENT
Employer
Dates Employed
Wages
Supervisor / Contact Number
Reason for Leaving
First:
Employer
Dates Employed
to
Wages
$
Supervisor / Contact Number
Reason for Leaving
Second:
Employer
Dates Employed
to
Wages
$
Supervisor / Contact Number
Reason for Leaving
Third:
Employer
Dates Employed
to
Wages
$
Supervisor / Contact Number
Reason for Leaving
Do we have permission to contact your employer?
HEPATITIS B VACCINE DETERMINATION
I understand that due to my occupational exposure to blood and/or other potentially infectious materials, I may be at risk of acquiring the Hepatitis B virus (HBV) infection. I understand that upon exposure, I am to contact the office immediately and a confidential medical evaluation and follow- up will then be made available. Included in this medical evaluation will be the opportunity to receive the Hepatitis B Immune Globulin (HBIG) vaccination at no charge to me.
Please check box and insert your name next to ONE of the following:
SIGNATURE
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts shall be cause for dismissal if employed. My typed name below shall have the same force and effect as my written signature when submitted electronically.
GENERAL QUESTIONS
Please complete this brief questionnaire. This will give DRD some insight as to what your employment interests may be. Take your time and fill this form out completely. Return this form with your completed employment application.
What position are you applying for this summer?
(Prioritize your selection by using (1) for most desired position and (4) for least. 1, 2, 3 or 4 can only be used once for the entire section)
Do you want to work full-time or part-time? Full-time (30-40hr) Part-time (20-30hr)
Do you currently have another job?
What are your requests for Time Off this summer?
If you are a Senior, what college will you be attending? (If known)
FOR COLLEGE STUDENTS
Are you planning to be an RA?
Are you an Orientation Leader?
Do you play a fall sport?
Are you interested in working pre-season?
FOR HIGH SCHOOL STUDENTS
Do you play a fall sport?
Are you a graduating senior in high school?
When is your Graduation?
When is your Senior Week?
When is your Senior Prom?