Application for Employment - Page 1

Personal Information:	Applicant Data:	Other information:
Full Name** Preferred Name Street Address** City** State** (2 Letter abbreviation) Zip Code**	Pool Preference Position Applied For How were you referred? Date Available to Start*(MM/DD/YYYY) * * Salary Requirements	Phone Number** () - Mobile/Pager/Other () - EMail Address** * *

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Background Information:
Have you ever worked for or applied to Northland Pool Management Company?* Yes No		If yes, when?
Are you a United States citizen?* Yes No If not, are you legally allowed to work in the U.S.? Yes No
Have you ever pleaded "guilty," or "no contest," or been convicted of a crime?* Yes No		If yes, please give the details and dates:

Education:
School Level	Name and Location	Years Attended	Did you graduate?	Subjects studied
High School			Yes No
College			Yes No
Other			Yes No
NOTE: A copy of your most recent grade card from school is required documenting an A/B grade point average. Please bring this with you to your interview.

Lifeguard/Water Safety Instructor/CPR/First Aid Certification Record Please list all certifications below, number of years held, sponsoring body (i.e. Red Cross, Ellis), and expiration date: General Please list your personal interests, hobbies, school activities, and extracurricular activities: Please list your special skills/training or qualifications:

*Required fields
**Required to receive email updates regarding scheduling, application status, etc.