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Position Request:

Dream ?Official DT Member


?Junior DT Member
?DT Sweetheart

Team
Application
DREAM TEAM APPLICANT INFORMATION
Nam
e: Last First Middle
Telephone: Email:

Alternate telephone: Address:


If necessary for the job, I am able to:
Are you age sixteen or over? Attend weekly meetings? Yes No
Yes No Provide a valid Life Guarding License? Yes No
Lifeguarding Experience (completed years): If so, fill out the following: Date Issued:
NEW 1 2 (Check one) Certifier:
3 4 5+ Job Type(s): Lifeguard (Waterparks) Head Lifeguard
I am legally eligible for employment in the U.S.? Manager Cashier
Yes No Maintenance Other: __________________
I am seeking a leadership position: Yes No Able to aid/perform the following the best: (check three)
I will be able to report to work CPR Shock Spinals Choking Rotating
days after being notified I am hired. Active First Aid ☐Other:

DREAM TEAM APPLICANT INCIDENT HISTORY


List four lifeguard related situations in which you had to perform assistance. Please list in order from most serious to least
serious. Be sure to briefly describe the situations while maintaining the proper privacy of the situation. Do not disclose
any names or certain times.

Skills performed: Brief description: Year: Facility:

Performance Reflection:

Job position held:


Skills performed: Brief description: Year: Facility:

Performance Reflection:

Job position held:


Skills performed: Brief description: Year: Facility:

Performance Reflection:

Job position held:


Skills performed: Brief description: Year: Facility:

Performance Reflection:

Job position held:

Rev. 6/2011 Dream Team Application Page 1 of 2


The Dream Team has well-qualified applicants. What do you feel makes you stand out? :

EDUCATIO
N
Institution
Years
name Field of study Graduate or degree
High school completed
College/univers
ity
Business/techni
cal Additional

HISTORY
Have you worked at a pool run by a different employer? ☐Yes ☐No
If yes, specify employer:

SKILLS &
QUALIFICATIONS
Other qualifications such as special skills, abilities or honors that should be considered:

Types of equipment you are qualified to operate or repair:

Professional licenses, certifications or registrations (exclude lifeguarding licenses):

Additional skills, including supervision skills, other languages or information regarding the career/occupation
you wish to bring to Dream Team’s attention:

REFERENCES
List two professional references from the Aquatics Facility at the Elk Grove Park District.

Name Occupation Years known

Name Occupation Years known

CONTACT
Are you capable of sending and receiving text messages? ☐Yes ☐No
If yes, please list the phone number: _____________________________________________________

INFORMATION TO THE
APPLICANT
As part of our procedure for processing your Dream Team application, your personal and professional references may be
checked. If you have misrepresented or omitted any facts on this application, and are subsequently selected, you may
be discharged from your membership. You may make a written request for information derived from the checking of
your references.
You understand that the Elk Grove Park District does not endorse this activity and does not formally supervise Dream
Team events. I understand and agree to the information shown above.

Signature of Applicant Date


Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all
employers are required to provide equal employment opportunity and may ask your type of certification, race and sex for planning and
reporting purposes only. This information is optional and failure to provide it will have no affect on your application for Dream Team
membership.
Developed by the Dream Team Division of Labor & Workforce Development, Membership Security Division.
Rev. 6/2011 Dream Team Application Page 2 of 2