Employment Application

Princeville Aquatic Center Village of Princeville
Employment Application
An Equal Opportunity Employer

Qualified applicants receive equal consideration. No question is asked for the purpose of excluding any applicant due to race, color, religion, sex, age, national origin, ancestry of physically or mentally handicapped as related to ability as is outlined in State and Federal laws or in Executive Orders.

  • Person to notify in case of emergency:
  • 3. Education
  • Date attended
  • 4. Health
  • 5. Employment History

    Give a complete account of your previous employment, including military service. List your most recent employer first.

  • 6. References (List 3 references, other than relatives)
    Name     Address    Phone    Years Known    Business Relationship
  • 7. Lifeguard Certifications
  • If yes, please provide a copy of your certificate to the Princeville Village Hall.
  • If yes, please provide a copy of your certificate to the Princeville Village Hall.
  • I am willing to have a medical examination. I authorize my former employers and listed references to give information concerning me, whether or not it is in their records, and I release them and their companies from any liability whatsoever. I certify that all statements given on this application are correct, and realize that falsification or misrepresentation of this or any other personal record may prevent employment, I agree to abide by all present and subsequently issued rules of the Village of Princeville.