Lifeguard Form


Contact Information


High School


Graduate School

Work Experience

Previous Employer 1

Employer 2

Include type of certification, the issuing agency, and expiration date.


Please list two responsible people who can testify to your good character other than family members or previous employers:

Reference 1

Reference 2

Please note that all successful candidates must be strong swimmers, as determined by the Water Safety Supervisor, and are subject to a swim test. The Lake Barcroft Association accepts applications from all people regardless of sex, race, religion, national origin, or disability.

Files must be less than 2 MB.
Allowed file types: gif jpg png pdf doc docx.