WHITE MEADOW LAKE – 2026 BEACH & POOL STAFF APPLICATION 
NAME:_____________________________________________     DATE:________________________________________________________
ADDRESS:___________________________________________    CITY, STATE, ZIP________________________________________________
E-MAIL________________________________________________ PHONE:_____________________________________________________
POSITION DESIRED:  	􀀀 HEAD LIFEGUARD      		􀀀 LIFEGUARD      
BATHING SUIT SIZE:____________________ (MEN: S/M/L/XL/XXL; WOMEN: 32,34,36,38, etc.) 

T-SHIRT SIZE:____________________ (S – M – L – XL)

CERTIFICATIONS					               DATE CERTIFICATION EXPIRES 
• LIFEGUARDING WITH WATERFRONT/FIRST AID* 	  __________________________
• LIFEGUARDING WITHOUT WATERFRONT/FIRST AID* 	  __________________________

*VALID CERTIFICATION REQUIRED FOR EMPLOYMENT (INDIVIDUALS WILL NOT BE SCHEDULED UNLESS THEY ARE CERTIFIED)
EDUCATION: 
HIGH SCHOOL__________________________ 		CERTIFICATE/DATE_______________________________	_____
COLLEGE_____________________________ 		DEGREE/DATE_______________________________		_____
GRADUATE SCHOOL___________________ 		DEGREE/DATE_______________________________		_____

WHEN ARE YOU AVAILABLE FOR A (PHONE) INTERVIEW? (Please list school breaks or days off) 
__________________________________________________________________________________________________________________
INDICATE PREFERENCES: 
_____ FULL-TIME EMPLOYMENT FROM MEMORIAL DAY TO LABOR DAY 
_____ PART-TIME EMPLOYMENT (Lifeguards Only) Please list days/hours available: _____________________________________________
_____ I WOULD BE AVAILABLE TO FILL IN AS NEEDED (SUBSTITUTE) 

If under 18, list age as of Memorial Day Weekend _____________ Working papers required. 

NO PERSON WILL BE ALLOWED TO WORK UNLESS ALL THEIR PAPERWORK, COPIES OF CERTIFICATIONS AND WORKING PAPERS (necessary for applicants under 18 years of age) ARE ON FILE WITH THE POA OFFICE BEFORE EMPLOYEMENT BEGINS. 

I authorize investigation of all statements herein, including any checks of criminal records, and release the POA and all others from liability in connection with the same. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters that status. Furthermore, I understand that any agreement must be in writing and signed by the designated POA official. I also understand that misrepresentations or falsifications herein or in other documents completed or submitted by the applicant will result in dismissal, regardless of the date of discovery. 

Signature _____________________________________________________	Date ______________________
                          Parent Signature is required if applicant is under 18

The information I have supplied to the questions on this application is truthful and accurate to the best of my knowledge. I understand that completing and submitting this application does not guarantee me a job.

Signature ______________________________________________________	Date _______________________

100 WHITE MEADOW ROAD, ROCKAWAY, NJ 07866
White Meadow Lake Property Owners Association is an Equal Opportunity Employer