Loyalist Township Aquatic Staff Recruitment Expression of Interest

Please complete this form to indicate your interest in joining the recruitment incentive program for Aquatic Staff at the new aquatic facility at the W.J. Henderson Recreation Centre (322 Amherst Drive, Amherstview ON).

If you are filling out this form on behalf of someone else, like a dependent, please make sure you include their information and not yours.

All individuals who complete this form will be contacted with information on next steps.

Notice of Collection

Personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25, as amended, to collect interest in participating in an incentive program to become a member of the Aquatic Staff at the new aquatic facility in Loyalist Township. Questions about this collection should be directed to:

Aquatics Coordinator
Community & Customer Services Department
P.O. Box 70, 263 Main Street
Odessa, Ontario K0H 2H0 or by contacting Recreation.

Alternate formats of this form are available by contacting Recreation.

Your Name:

Date of Birth:

Email:

Phone Number (123-456-7890):

Tell us a bit about yourself and why you want to be a lifeguard and swimming instructor?

Have you worked or volunteered in a leadership role with children before?

Yes

No

Have you worked or volunteered with seniors before?

Yes

No