Thank you for your interest at working at the STSC swimming pool the summer. We are looking for people that love being both a swim instructor and a lifeguard. The ideal employee will have an enthusiastic work ethic, will be there to help by making a high quality contribution to our professional, small, and busy staff. STSC Pool Staff members are responsible for saving lives as well as picking up trash and everything in between. We look forward to receiving your application. STSC Swimming Values: Affirm each others strengths and protect each others weakness. Seek to understand others FIRST, BEFORE trying to be understood. Praise each other in public, Correct in private. Treat others the way you want to be treated. Build positive relationships with families. STSC Swimming Mission Statement: To provide a clean, safe, and happy environment at all times. To provide a high standard of excellence in teaching and lifeguarding The Ideal STSC Swimming Staff Member Will: Be friendly and nice to all people. Create a safe and happy experience for all. Do all jobs to keep our work space clean at all times. Give every student the best of your ability and expertise. Keep all necessary certifications current. Be able to commit to Full Time shifts and will not need substitutes. Will attend all staff training and become a great instructor and lifeguard. Employees will be provided: Rash Guard (to be worn at all times when working) T shirt Hat First Aid fanny packs (Worn at all times, unless in the water teaching) Employees will provide their own: Sunscreen Black Athletic Shorts One piece, solid Black or Green Swimsuit Water and Food Foot protection: Athletic or Rugged Sandals Towels We look forward to getting your application. Once it has been received we will be in contact to with you to let you know that we received it. Applications will be taken from January 27th June 15th, once our staff is full we will stop accepting applications. Thank you for your interest in working at STSC Pool this summer.
Personal Information: Last Name: First Name: MI: Phone: Email: Address: City: State: Zip: Social Security Number: Birthday: Gender: M / F T Shirt/Polo Size: Rashguard Size: Schedule Preferences: Available Lifeguard/Swim Instructor shifts: please rank your shift preferences: (Rank 1 as your most wanted schedule and 8 as your least wanted schedule) 8 AM 4:30 PM M TH 11 AM 7:30 PM M TH 8 AM 4:30 PM M F 12 PM 7:00 PM Sat 12 PM 7:00 PM Sun 8 AM 4:30 PM M TH 11 AM 7:30 PM M TH 11 AM 7:30 PM M F 1 PM 7:00 PM Sat 1 PM 7:00 PM Sun 8 AM 4:30 PM M F 1 PM 7 PM Sa Su Vacation Section: List all of your vacations so we can cover all your shifts before the summer begins, the ideal employee will miss no more than one week of the work between June 17 August 19, 2018. List all vacations dates you have scheduled for this summer: Personal week or weeks off: Other Personal days off: Certifications: CPR / First Aid: Lifeguard: WSI / Other References: (list at least two references personal and/or professional)
Previous work experience: (If you have had a job before please fill out this section completely.) Employer: Ph: Email: Dates of Employment: Do you give permission to STSC/BOS to contact this person: Y or N What did you enjoy most about this job? What did you enjoy least about this job? Employer: Ph: Email: Dates of Employment: Do you give permission to STSC/BOS to contact this person: Y or N What did you enjoy most about this job? What did you enjoy least about this job? Sign and Consent: I confirm that the information provided in this application is both truthful and accurate. I give permission for STSC/BOS to contact my references. I have omitted no facts that could affect my employment. I understand that any false misleading statements could place my potential employment in jeopardy. Printed Employee s Name Signature of Employee Date If you are under 18 year old, you must have your legal guardian sign this application: Printed Legal Guardian s Name Signature of Legal Guardian Date Application received on: Initials: Applicant can return this completed application: Via email in.pdf form to blueoregonswimming@gmail.com or it can be mailed to this address: Geoff Tiffany, BOS Manager, 4968 Circuit Rider Ln S, Salem Oregon 97302. If you need more instructions call Geoff at 503 302 7659
Drug and/or Alcohol Testing Consent Form: I hereby agree, upon a request made under the drug/alcohol testing policy of Blue Oregon Swimming (the company), to submit to a drug or alcohol test and to furnish a sample of my urine, breath, and/or blood for analysis. I understand and agree that if I at any time refuse to submit to a drug or alcohol test under company policy, or if I otherwise fail to cooperate with the testing procedures, I will be subject to immediate termination. I further authorize and give full permission to have the Company and/or its company physician send the specimen or specimens so collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relating to such test to the Company and/or to any governmental entity involved in a legal proceeding or investigation connected with the test. Finally, I authorize the Company to disclose any documentation relating to such test to any governmental entity involved in a legal proceeding or investigation connected with the test. I understand that only duly authorized Company officers, employees, and agents will have access to information furnished or obtained in connection with the test; that they will maintain and protect the confidentiality of such information to the greatest extent possible; and that they will share such information only to the extent necessary to make employment decisions and to respond to inquiries or notices from government entities. I will hold harmless the Company, its company physician, and any testing laboratory the Company might use, meaning that I will not sue or hold responsible such parties for any alleged harm to me that might result from such testing, including loss of employment or any other kind of adverse job action that might arise as a result of the drug or alcohol test, even if a Company or laboratory representative makes an error in the administration or analysis of the test or the reporting of the results. I will further hold harmless the Company, its company physician, and any testing laboratory the Company might use for any alleged harm to me that might result from the release or use of information or documentation relating to the drug or alcohol test, as long as the release or use of the information is within the scope of this policy and the procedures as explained in the paragraph above. This policy and authorization have been explained to me in a language I understand, and I have been told that if I have any questions about the test or the policy, they will be answered. I UNDERSTAND THAT THE COMPANY WILL REQUIRE A DRUG SCREEN AND/OR ALCOHOL TEST UNDER THIS POLICY WHENEVER I AM INVOLVED IN AN ON THE JOB ACCIDENT OR INJURY UNDER CIRCUMSTANCES THAT SUGGEST POSSIBLE INVOLVEMENT OR INFLUENCE OF DRUGS OR ALCOHOL IN THE ACCIDENT OR INJURY EVENT, AND I AGREE TO SUBMIT TO ANY SUCH TEST. Printed Employee s Name Signature of Employee Date If you are under 18 year old, you must have your legal guardian sign this form: Printed Legal Guardian s Name Signature of Legal Guardian Date Printed BOS Representative Signature of BOS Representative Date
Parent Section: (Legal Guardian of any applicant under 18 years old) If you are under the age of 18, your consenting legal guardian will need to fill out this section: Parents thank you for giving us this opportunity to hire minors between 15 and 17 years old. We beleive in giving kids these work opportunities. Please fill out the below information so we can give all of our employees and clients a great experience at STSC. Legal Parent/Guardian Name: Ph: Email: Legal Parent/Guardian Name: Ph: Email: Emergency contact: Ph: Doctor s contact: Ph: We will contact a doctor only if we fail tp contact the parents or emergency contact, in a medical emergency. Statement: I, as the parent (legal guardian) of, agree to all the following statements below. 1. I give permission for my child, under 18 years old, to work for at STSC for Blue Oregon Swimming, LLC. (BOS is a swimming pool management company that operates STSC swimming pool.) 2. I have read, understand, agree, and support my child s Schedule Preferences. My child has my permission to work up to 40 hours a week while employed at BOS. 3. I agree that it is essential that I communicate directly with BOS regarding all family vacation time as soon as possible so that BOS can find substitutes for my child s time off and that if additional personal time is needed that I will contact my child s supervisor via email at blueoregonswimming@gmail.com, as soon as I know the dates for additional personal time off. 4. I agree that if my child is having a life threatening emergency while working, STSC/BOS will activate emergency medical services. By signing this agreement I authorize the staff at STSC/BOS to seek immediate medical attention for my child. 5. I agree with and have signed the BOS Drug and Alcohol testing consent form in this application. 6. I agree that my child is bound to the same BOS procedures and practices that all BOS employees are subject to as outlined in the BOS Employee handbook. Sign: Printed Parent / Legal Guardian s Name Signature of Legal Guardian Date Printed BOS Representative Signature of BOS Representative Date