CBC Pool Management

120 Lyle Ave,

Bala Cynwyd, PA, 19004

Phone:610.321.0299 Fax:1.866.811.3773

Email:employment@cbcpoolmanagement.com

If you wish to be considered for a position, please complete the following job application form.

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Name:

Street Address:

City:


State:
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Zip Code:

Age:


E-mail Address:


Mobile Phone Number

Home Phone Number(s):

Area of Interest:
Lifeguard Lifeguard Manager Instructor

Labor Substitute Lifeguard

I am interested in:
Full Time * Part Time

*Full-time consists of 360 total scheduled and worked hours throughout the season with no set restrictions on

availability and ability to work two of the three holiday periods*

Military Experience
If no military experience, please skip to the next section.

Branch of service:

Specialty:

Description of work/experience:

Date of enlistment: Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Date of discharge : Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Relevant Certifications

Certification Type:

Date of Issuance: Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Date of Expiration : Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Certification Type:

Date of Issuance: Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Date of Expiration : Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Certification Type:

Date of Issuance: Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Date of Expiration : Select 1 2 3 4 5 6 7 8 9 10 11 12 Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Select 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Position Desired:


Salary Desired:
/hr.

Are you presently employed?
yes no

If yes, may we inquire with your present employer?
yes no

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Please fill out the name of schools you have attended.

High School:

Name:

Location:

Years you attended this school: to

Did you graduate?
yes no

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University / College:

Name:

Location:

Years you attended this school:

What did you study?

Did you graduate?
yes no

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Other schools attended:

Name:

Location:

Years you attended this school:

What did you study?

Did you graduate?
yes no

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Please list your last two employers, starting with the most recent.

Present / Last Employer:


Phone Number:


City:


State:


When were you employed?
From: To:

Job Title:


Starting Salary:
/hr.

Ending/Present Salary:
/hr.

Name of Supervisor:


May we contact your supervisor?
yes no

Description of Work:


Reason for Leaving:

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Previous Employer:


Phone Number:


City:


State:


When were you employed?
From: To:

Job Title:


Starting Salary:
/hr.

Ending/Present Salary:
/hr.

Name of Supervisor:


May we contact your supervisor?
yes no

Description of Work:


Reason for Leaving:

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Have you ever been convicted of a felony?
yes no

If yes, please explain:


A "yes" answer will not necessarily disqualify you from consideration.

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Authorization

I certify that the facts contained in this true and complete the best of my knowledge and understand that, if employed, falsified statements on this questionnaire will be grounds for dismissal.

I authorize investigation of all statements contained herein and the employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and I release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree to the guard contract and understand that adherence to this contract and my submitted schedule and availability are necessary

preconditions for my continued employment, bonuses, reimbursements and raises.

I understand that my performance and schedule bonus will be significantly impacted by any missed shifts, and/or significant lateness, including missed shifts due to undocumented illness, or

“family emergencies”. I understand that this is “at will” employment and that such behaviors may result in my immediate termination, depending on the circumstance, as well as my history with the company.

I understand that CBC pays all of its employees biweekly by direct deposit only and that I will need to provide a voided check, or savings account slip with my account and routing number at least one week before my first paycheck is due to receive it at that time, and that CBC uses a digital time tracking system to monitor hours and that failure to punch in or out may delay the payment for that day until the next payroll period.

I also understand that the discount rate for Lifeguarding, First Aid, And CPR certification and/or re-certification arranged by CBC is conditional upon this same precondition and my failure to properly

execute the lifeguard contract, choice to leave, or dismissal both will result in an amount of up to $300.00 for full certification. due for receipt of the certification cards, which otherwise will be kept on file

and sent to me after the season is over, and in the event of my dismissal, voluntarily or otherwise, these charges as well as those for uniforms not returned clean and in new condition will be deducted from

any outstanding paycheck, and referred to a third party collection entity if not fully remitted within 30 days.

Name:

Date:

Legal Guardian Name (If Under 18):

Date: