Skip Navigation
Welcome to the website for the town of Rutland, Massachusetts
This table is used for column layout.

On Our Site
Search Our Site
Site  This Folder
 
Advanced Search
 
Rutland Town Pool
Lifeguard Application

Name:  _______________________________________

Address:  _____________________________________

Home Phone:  _________________Cell Phone: _________________

Email: _____________________________

Emergency Contact:  _______________________Phone: _____________

S.S.N.: _______________ D.O.B. _____  Grade entering:  ___________

Position applying for: __________________________

Are you WSI certified   y   n     or  Lifeguard certified     y   n

Is your certification in First Aid/CPR current?  y     n

Reference (1):  _________________________________
                (2):  _________________________________

Past Experience (list all):

Please list any days you cannot work between June 20th and August 25th *

As a staff person, I understand that part of my responsibilities is to accept direction from my senior staff and the head life guard.  I understand that I may not be offered the position I have applied for, and have the right to refuse that position which is offered to me.  I also understand that I am not guaranteed a position by completing this application.

Signature:______________________________Date:__________

* Tentative opening and closing dates for the Town Pool summer 2014
Rutland Town Pool
Application for Employment

Name:  _______________________________________

Address:  _____________________________________

Home Phone:  ____________________Cell Phone: __________________

Email: __________________________________

Emergency Contact:  ___________________________

Emergency Phone:  ____________________________

S.S.N.: _______________ D.O.B. _____  Grade entering:  
  
Position applying for: __________________________


Reference (1):  _________________________________
                (2):  _________________________________

Past Experience (list all):


Please list any days you cannot work between June 20th * and August 25th *


As a staff person, I understand that part of my responsibilities is to accept direction from my senior staff.  I understand that I may not be offered the position I have applied for, and have the right to refuse that position which is offered to me.  I also understand that I am not guaranteed a position by completing this application.

Signature:______________________________Date:__________

* Tentative opening and closing dates for the Town Pool summer 2014



 
Town of Rutland 250 Main Street, Rutland, MA 01543   Disclaimer
Virtual Towns & Schools Website