Stuart Heights Lifeguard Application

Summer 2023

Name: ____________________________ Application Date: _______________

Address: ______________________________________________________________________

Cell number: ______________________ Email Address: ______________________________

Date of Birth: ______________________ Current Age: ______________

Grade in August: 9th     10th    11th    12th

Year in College: Freshman      Sophomore      Junior      Senior     Super Senior


Date of Lifeguard Certification :__________ Years of experience:_______


Dates you are available to work this summer: FROM: ___/___ TO: ___/___ ( the pool is open from 5/27 to 9/4)

How many hours a week would you like to work? ______

Any dates (vacation, college orientation, sports, etc.) that you are NOT available to work this

Please submit to and also text a picture to Phil Lesselroth at 423-400-2757