Employment Application

Please complete the following fields and then click the submit button at the bottom of the page. Your application will be emailed to our management team for review.

Full Name: *

Address: *

Phone: *

Email: *

Date of Birth: * 12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 19401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010

---

What is your current level of education: *

Grades 9-10
Grades 11-12
High School Graduate
Some College
College Graduate
Some Grad. School
Graduate Degree

Please provide your date of graduation, as well as the name and state of your high school:

Please list any certifications or qualifications you have (WSI, CPR, First Aid, etc.)::

Please specifiy the days and times you are available to work after June 1, 2009:

Please list your previous places of employment, starting with the most recent. Please provide your dates of employment, the name and address of the business, your title and responsibilities, rate of pay, and reason for leaving *

Please provide at least three references. For each, please provide their full name, contact information, and their title/your relationship: *

Have you ever been convicted of a crime? If yes, please explain: *

Is there any reason that makes you inelligible to work with children? If yes, please explain: *

Are you legally eligible to work in the United States?

Yes
No

By initialing the box below, I certify that my application and all attachments are true and complete to the best of my knowledge. I understand that any incorrect, incomplete or false statements or information furnished by me may, at the discretion of At Home Aquatics, disqualify me from employment, or cause my dismissal. I hereby authorize At Home Aquatics to make a thorough investigation of my past employment and activities. I release from all liability At Home Aquatics, former employers, or any persons supplying such information. The language in this application is not intended to create, nor is it to be construed to constitute, a contract of employment.

Initials *

Date 12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 20092010