Apply for Lifeguard / Water Safety Instructor

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Lifeguard / Water Safety Instructor
ID:REC - 1001
Location:Milbank, SD
Department:Recreation
Job Type:Non-exempt (hourly)
Salary Range:$14.51/ hr. starting, DOQ
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
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Application for Employment
PERSONAL INFORMATION
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EMPLOYMENT DESIRED
Full Time   Part Time   Seasonal
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EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School 1

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School 2

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School 3

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School 4

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School 5

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EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

Employer 1

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Employer 2

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Employer 3

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Employer 4

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Employer 5

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REFERENCES

Please provide three professional references (not relatives).

Reference 1

Reference 2

Reference 3
AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the City to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

Additional Employment Questions
* Please  tell us why you are interested in this opportunity with the City of Milbank:
* Do you have any relatives that currently work for the City of Milbank?:
Yes
No
If yes, please provide their name(s):
* Have you ever been convicted of a felony?
Please note that an answer of "Yes" does not disqualify you as a candidate. The nature of the offense, date and the position for which you are applying are all considered carefully.:
* Do you have a valid Driver's License?:
Yes
No
* Please provide your driver's license number:
* State and Class of License:
* Have you had your driver's license suspended or revoked in the last 3 years?:
Yes
No
If yes, please explain.:
Applicant Statements
Please read and select "YES" to indicate that you have read and understand the following information.
* I hereby certify that the information given by me in this application is true and complete to the best of my knowledge. I further authorize investigation of all statements I have made. Misrepresentation, falsification, or omission of facts called for in this application or in the interview process is cause for cancellation of this application or termination of employment. Incomplete applications will not be considered.:
Yes
No
* I hereby understand and acknowledge that, unless otherwise defined by applicable law, initial and ongoing employment with the City of Milbank is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge an Employee at any time with or without just cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless change is specifically acknowledged in writing by an authorized executive of this organization.:
Yes
No
* I authorize the investigation of any or all statements contained in this application. I also authorize, which listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.:
Yes
No
* I understand that it is my responsibility to communicate if I need any work accommodations to perform the duties for the opportunity for which I am applying. The City of Milbank will not make any assumptions about a candidate's ability or inability to perform the duties of the position.:
Yes
No
* Upon employment, employees will receive compensation through direct deposit to a financial institution. Payroll occurs bi-weekly. I understand that this application does not constitute a contract or guarantee employment, or if employed, does not bind either party to a specific period of employment.:
Yes
No
Authorization for Reference Requests
* I have applied with the City of Milbank for employment and I desire that they be fully advised of my record with former employers and schools that I have attended. I, therefore, give my permission and request that former employers and prior schools attended furnish any and all requested information and records to the City of Milbank on their request for references in regard to the position for which I  am applying. In addition, I hereby release all involved parties from any and all legal liability of damages for requesting or providing the reference information.:
Yes
No
Equal Opportunity Employment
It is the policy of the City of Milbank to provide equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, the City of Milbank will provide reasonable accommodations for qualified individuals with disabilities.

Our employment processes and practices are designed to comply with all applicable federal, state and local laws, directives and regulations and cover all human resource actions including employment, compensation, benefits, training, education, tuition assistance, transfers, promotions and social programs/events.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
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Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
I Choose Not to Respond
Veteran Status: (Please check all that apply)
Individual with a Disability
An individual with a disability is a person who has a physical or mental impairment which substantially limits one or more of such person's major life activities, or who has a record of such impairment.
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
I Choose Not to Respond

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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