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Application for Employment City Website: http://www.cityofcody-wy.gov Email:[EMAIL REDACTED] 1338 Rumsey Ave. PO Box 2200 CODY, WY 82414 (307) 527-7511 An Equal Opportunity Employer AQUATIC SEASONAL Cff'I· OP" Qx:,y WYO r:N C POSITION APPLIED FOR DATE OF APPLICATION__ _ _ LAST FIRST MIDDLE LIST OTHER NAMES USED, IF ANY _ MAILING ADDRESS STREET OR PO BOX CITY STATE ZIP CODE PRIMARY TELEPHONE NUMBER ( ) - AL TERNA TE TELEPHONE NUMBER ) _ EMAIL ADDRESS _ Are you under the age of 14? YES D NO D Are you over the age of 18? YES D NOD (For Police Officers in WY, the minimum age is 21) Have you ever been employed by the City of Cody? YES D NO Dlf yes, give 1 understand, if hired, I will be required to provide proof of eligibility to work in the United States. YES D NO D Have you ever been convicted of any law violation other than a minor traffic violation? YES D NO D ("YES" answer does not automatically disqualify you from employment since the nature of the offense, date and the Job for which you are applying will also be considered.) If yes, give details: Are you related to anyone presently working for the City of Cody? YES D NO Df Yes, list Do you have a valid license? YES D NO D Driver's License# STATE? Do you have a Commercial Driver's License? YES D NO D (A,B,C) Endorsements Held: Hazardous Material D Tanker D Airbrakes D Passenger D Have you ever been terminated, dismissed or asked to resign from any positiooYES D NO If yes, please explain . Educational Background COLLEGE/UNIVERSITY/TRADE SCHOOLS CITY/STATE High School: CREDITS COMPLETED DEGREE/ DIPLOMA YEAR MAJOR MINOR ---PAGE BREAK--- ---PAGE BREAK--- CERTIFICATION OF ACCURACY & AUTHORIZATION TO RELEASE INFORMATION I certify that all information provided in this application is true and complete. I understand misrepresentation or omission of facts during the application or selection process may disqualify me from further consideration and may be cause for dismissal. I understand the City of Cody may conduct a background investigation, which may include obtaining information as to my character, reputation, and mode of living. This may include interviews with my relatives, neighbors, friends, former employers, schools and others. I authorize the City of Cody to investigate my employment background and personal history. I authorize the City of Cody to obtain any and all information relevant to determining my qualifications for the job for which I have applied. I further authorize the City of Cody to obtain copies of and review any and all employment records, documents and such other information as the City of Cody may determine relevant to its investigation. I agree to sign an authorization and consent to release of information to allow the City of Cody to obtain copies of prior employment records, documents and information from prior employers, organizations, references, and individuals who may have information relevant to my qualifications to work for the City of Cody. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I understand that I may also be required to successfully pass drug and alcohol screening examinations. I hereby consent to pre- and/or post-employment drug and alcohol screens as a condition of employment, if required. I have read, understand, and by my signature, consent to these statements. I authorize investigation of all information contained in this application. Signature of Applicant Date ALL APPLICANTS OVER AGE 18 must complete the Application for Child & Adult Abuse/Neglect Central Registry Screen Document (pages 5/6 of application and return with application) ---PAGE BREAK--- Aquatics Division Job Title Rate of Pay Aquatics I $9.49 Aquatics II $10.12 Aquatics III $11.39 Aquatics IV $15.30 Aquatics I: Duties include serving as an aide during swimming lessons, dispatching patrons down the water slide, interacting with the public and assisting with custodial duties. Employee must be willing to communicate clearly and concisely with the public of all ages. Employees must be at least 14 year of age and available to work approximately 10-40 hours per week depending upon the season including evenings, weekends, and holidays. May assist other City divisions as assigned. Aquatics II: Employees must be certified through the American Red Cross as either a Lifeguard or Water Safety Instructor and be certified in CPR (preferably Professional Rescuer). Water Safety Instructor’s must be at least 16 years of age and duties include planning, instructing and evaluating the American Red Cross Learn to Swim program. Employee must be able to assess swimming skills for various levels and determine appropriate instruction. Lifeguards must be at least 15 years of age and duties include patron safety, recognizing unsafe conditions, implementation of safety protocol, and emergency response. Employees will assist with custodial duties and water testing and maintenance. Employees must be able to communicate clearly and concisely with patrons of all ages. Employees are expected to demonstrate a high level of professionalism, maturity and responsibility. Participation in training and frequent skills review is mandatory. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. May assist other City divisions as assigned. Aquatics III: Employees must be certified through the American Red Cross as both a Lifeguard and a Water Safety Instructor and serve in both capacities on a regular basis. Duties of the Aquatics II apply to the Aquatics III position. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. Duties will be assigned based on qualifications and department needs. May assist other City divisions as assigned. Must be at least 16 years of age. Aquatics IV: Employees must be certified through the American Red Cross as Lifeguard or a WSI and serve in this capacity on a regular basis. Duties of the Aquatics II apply to the Aquatics IV position. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. Will perform as “shift supervisor” and be responsible for assigned staff during shift, implementation of shift duties/responsibilities, review daily and weekly maintenance logs. Review timesheets at the end of each day. Assist in performing duties associated with closure of pool area. Some light chemical usage/monitoring required. Duties will be assigned based on qualifications and department needs. May assist other City divisions as assigned. Must be at least 18 years of age in most positions. ---PAGE BREAK--- ONLY COMPLETE IF AGE 18 or OLDER ---PAGE BREAK--- ONLY COMPLETE IF AGE 18 or OLDER