Form Data Auditor

Swim Instructor Application Form Please complete all sections clearly and legibly. Section 1: Personal Information Full Name: Address: Phone Number: Email Address: Date of Birth: Emergency Contact Name: Emergency Contact Relationship: Emergency Contact Phone: Jane Elizabeth Doe 123 Ocean Drive, Coastal City, CA 90210 (555) 123-4567 jane.doe@email.com MM/DD/YYYY John Doe Brother (555) 987-6543 Section 2: Qualifications & Experience Current Certifications (Please list issuing organization and expiration date): Lifeguard Certification: American Red Cross, Exp. 12/2025 • Water Safety Instructor (WSI): American Red Cross, Exp. 12/2025 • First Aid: American Red Cross, Exp. 12/2025 • CPR/AED for Professional Rescuers: American Red Cross, Exp. 12/2025 • Other (e.g., Adaptive Aquatics): N/A Previous Swim Instruction Experience: I have 3 years of experience as a swim instructor at the Coastal City Community Pool. I taught group lessons for all ages, from parent-and-tot to adult beginner classes. I also provided private lessons focusing on stroke refinement and water safety. Please list age groups you have experience teaching: Infants/Toddlers (6 months - 3 years) • Preschool (3-5 years) • School-age Children (6-12 years) • Teenagers (13-17 years) • Adults (18+ years) Do you have experience working with individuals with special needs or disabilities? If yes, please describe: Yes, I have experience working with children on the autism spectrum, adapting lessons to their communication styles and sensory needs. I also worked with a visually impaired adult, focusing on verbal cues and tactile guidance. Section 3: Availability Preferred Days/Hours of Availability: Earliest Start Date: Monday-Friday, 3:00 PM - 7:00 PM; Saturdays, 9:00 AM - 2:00 PM June 1, 2024 Section 4: References https://rightbrain.ai Please provide two professional references who can speak to your experience and character. Reference 1: Name: Relationship: Phone Number: Email Address: Sarah Chen Former Supervisor, Coastal City Community Pool (555) 234-5678 sarah.chen@communitypool.org Reference 2: Name: Relationship: Phone Number: Email Address: Mark Johnson Colleague, Coastal City Community Pool (555) 345-6789 mark.johnson@communitypool.org Section 5: Additional Information Why are you interested in this swim instructor position? I am passionate about water safety and teaching individuals of all ages to swim. I believe that swimming is a life skill that brings joy and confidence. This position aligns perfectly with my experience and my desire to contribute to a community-focused aquatic program. Describe your philosophy on teaching swimming: My philosophy centers on creating a positive, encouraging, and safe learning environment. I believe in breaking down skills into manageable steps, celebrating small victories, and adapting my teaching style to meet the individual needs of each student. Building trust and making learning fun are paramount. Section 6: Declaration I certify that the information provided in this application is true and complete to the best of my knowledge. Applicant's Signature: Jane E. Doe Date: May 15, 2024 https://rightbrain.ai