EMPLOYMENT APPLICATION
Leisure Recreation Group
Please fill out the following employment application form:
Facilities
..Choose our location
Chilliwack - Cheam Centre
Abbotsford - Centennial Park
Chilliwack - Chilliwack Landing Leisure Centre
Chilliwack - Rotary Pool
NOTE: Please indicate which facility you are interested in. Failure to do so will delay your application.
Personal Information
Name
*
Address
*
City
*
Province
*
Postal*
Date available to start work
(day/month/year)
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Phone
*
Fax
Email
* required fields
Area of Interest
Aquatics
Dryland Programs
Marketing
Maintenance
Aerobics and Aquafit
Weight Room
Special Events
Janitorial
Registrations / Admissions
Office / Administration / IS
Concession / Retail
Other:
Aquatic, Fitness, First Aid and Related Certification
Certification
Expiry date
Location and date of original course
NLS
(*advanced lifeguard training inte'l)
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02
03
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11
12
2004
2005
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2014
ALT Certification*
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11
12
2004
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2011
2012
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2014
CPR*
(*specify ticket)
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03
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11
12
2004
2005
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2007
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2009
2010
2011
2012
2013
2014
First Aid*
(*specify ticket)
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02
03
04
05
06
07
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09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Pool Operator
01
02
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04
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06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Red Cross Instructor
(WSI)
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Life Saving Instructor
01
02
03
04
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06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Life Saving Examiner
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Diving Instructor
(spring board)
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
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2014
Prov. Certification Fitness Theory
01
02
03
04
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06
07
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09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
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2014
Prov. Certification Weight Training
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
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2014
Prov. Certification Personal Training
01
02
03
04
05
06
07
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09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Prov. Certification Group Fitness
01
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2011
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2014
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2011
2012
2013
2014
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12
2004
2005
2006
2007
2008
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2010
2011
2012
2013
2014
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02
03
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06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Other Related Certification and Education
Certification
Expiry date
Location and date of original course
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
01
02
03
04
05
06
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08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
01
02
03
04
05
06
07
08
09
10
11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
01
02
03
04
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06
07
08
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11
12
2004
2005
2006
2007
2008
2009
2010
2011
2012
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2014
Work Experience
Employer and phone number
Dates
Job title and duties
Supervisor
Reason for leaving
1.
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
to
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2.
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
to
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
3.
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
to
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
4.
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
to
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
5.
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
to
01
02
03
04
05
06
07
08
09
10
11
12
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Other Skills, Experience and Certifications
Professional Work References
I hereby certify:
1. That the information given on all applicant documents is true and I understand that
any untrue statements may be grounds for dismissal.
2. That by submitting this form I give permission to Leisure Recreation Group to
contact my present/past employers to obtain references.
3. That I am willing to obtain at my own cost and submit a personal criminal record
check as pre-condition of my employment with Leisure Recreation Group.
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