+POOL Lifeguard Training Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thanks for your interest in the +POOL Lifeguard Training in Partnership with the Lower East Side Employment Network!

Please complete the application below and note that completion of the form does not guarantee acceptance into the program.

Email *

What is your name?

What is the best phone number to reach you?

If we need to get in touch with you, what method would you prefer?

Email me.

Call me.

Other:

Clear selection

How old are you?

15 years old

16-17 years old

18+ years old

Clear selection

Have you obtained any of the following certifications? Select all that apply.

CPR

First Aid/AED

Lifeguarding (American Red Cross)

Lifeguarding (Other certification, not Red Cross)

Other:

How would you describe your level of swimming ability?

I am very comfortable swimming and treading water!

I can swim in shallow water, but need some support with the deep end.

I cannot yet swim, but I would love to learn.

I can swim, but cannot yet swim several laps continuously without stopping

Clear selection

Why are you interested in becoming a lifeguard?

I need a summer job!

I like the idea of helping people.

I like to swim!

I want to be outside or near a pool.

It seems like it'll be a good experience!

Other:

The pre-training program includes an hour of in-water instruction. This is offered in both the morning (before school) and afternoon (after school) hours. You must attend at least one skills course before the training classes so we can assess your readiness for the course.

Which training option would be best for your schedule?

I am flexible with my schedule and can train during any hours.

I prefer to train in the morning.

I prefer to train in the afternoon.

Clear selection

Lifeguard Certification includes 8-10 hours of online coursework.

Do you have regular access to an internet-accessible tablet, laptop, or computer?

Yes, I have access to both the internet and one of the devices listed above.

I have a device, but may need support with internet access.

I may need support with internet access and a device to complete the coursework.

Clear selection

Lifeguard Certification also includes in-water training that teaches skills needed for a professional rescuer, and 2-3 hours of CPR and First Aid classroom instruction.

These certification courses will be offered Saturdays, April 27, May 4, May 11, and May 18 from 12pm-6pm at John Jay College, 524 West 59th Street.

Will you be available to attend a certification course on a Saturday on on of those dates and times?

Yes, I will attend a course on a Saturday.

Being available on a Saturday may be tough for me, but I will make it work!

I cannot be available on a Saturday.

Clear selection

Once participants obtain certification, Henry Street Settlement will help everyone identify, apply and interview for open lifeguard positions across the city.

Do you have a resume that you've already started working on or have completed?

Yes, I have a complete resume!

I have a resume that could use some work.

I need help creating a resume.

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Lower East Side Employment Network. Report Abuse

Forms