NEW EMPLOYMENT FOR LIFEGUARD ONLY

 Summer 2012

Name:                                                                                                                                             

Address:                                                                                                                                        

Phone #:                                                                   Date of Birth:                                                

S.S. #:                                                         School:                                                                       

Special Training:                                                                                                                             

Have you been hospitalized during the past year?                          (Y)                       (N)

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Lifeguard applicants must be 16 years of age by January 1, 2012 and present proof of up-to-date Nassau County Board of Health lifeguard certification and current CPR and first-aid certification.  (If you are renewing your certification or are in the process of obtaining certification for the first time, you must indicate that fact under ASpecial Training@ above and advise us of the date that certification will be received.)         

All applicants are subject to Nassau County Civil Service approval.

All applicants UNDER 18 years of age MUST submit working papers with this application.

All applicants must provide proof of a physical exam performed no earlier than June, 2011 with this application.

All applicants should be aware that there will be no time off permitted for summer vacation.

Completed applications will not be accepted until January 3, 2012 beginning at 8:30 AM.   Applications must be brought into Village Hall and left with the receptionist where they will be time-stamped. Applications dropped through the mail slot will not be accepted.  Applications are accepted on a first come, first served basis.

All applications that are received without the necessary documents will be returned.

I have reviewed and agree to the above-mentioned requirements.

_________________________________                              __________________

Applicant=s Signature                                                              Date  

Contact Susan Walsh at Village Hall if you have any questions at 326-6304.