Dominion Aquatics Application For Employment TEL:(703)866-0081 FAX:(703)866-0900
Full Name:
Social Security No:
Street Address:
City: State:
Zip Code:
Home Phone:
Date of Birth:
Education : H.S. College  Current Yr:
School Phone No. : (if applicable)

Date Available for Employment:    
Position Preferred:
Number of Years as a Lifeguard:
Distance You Can Travel:
Date You Must Leave:
Area Interested in Working:
Type Filters:
Salary Desired: $ per hour

Current Certifications 

 Expiration Dates



 Pool Operator's Permit  


 Community CPR (or equivalent)  


Other Qualifications (you feel may help us to place you):

Previous Experience


 Supervisor / Phone Number

Hrly. Rate

Reason For Leaving Last Employment:


Thank you for applying. Please call our office at (703) 866-0081 to follow up, if you do not hear from us within 72 hours.

Copyright   © 1999 - 2003  Kaus & Whitestone, Inc., T/A Dominion Aquatics