Surf City Yacht Club Application for Employment

Contact: Andrew Temme Application Date: 2/12/09 [email protected] 201-394-8799

Please take the time to fill out the following information and respond to the questions.

Personal Information (type into form fields) Name: e-mail: Current/School Address: Permanent Address: Phone: (H) (C) (SCH) Date of Birth (mm/dd/yy)

Position Desired (please place X) Sailing Assistant Instructor Racing Coach Date you can start: Last Date you are available: Are you available to work: Full Time Part Time Are you currently employed? Yes No If so, may we inquire with your present employer? Yes No

Education School Years Did you Major / Minor Name Attended Graduate? Secondary select select

High School select select

College select select

Other select select

Instruction Experience and History

Training: US Sailing Level 1 Date Certified US Sailing Level 2 Date Certified Other

Years of instruction experience as: Head Instructor / Coach Instructor

Do you hold a NJ Boating Safety Certificate? Yes No Course Date Do you hold current: CPR certification? Yes No First Aid training? Yes No

Special Skills and Training

Please list any other skills and/or training you feel may apply to this position

Sailing and Power Boating Experience

Please list the types of sailboats and powerboats which you have experience with. Boat Sailing/Racing? Skipper/Crew? Teaching? Yrs.Experience Type select select select select select select select select select select select select select select select select

Former Employers

Please list your former 3 employers starting with the most recent Dates Position & Club Supervisor Name & Salary Reason for Contact # leaving?

References List people that we may contact. At least one personal reference (teacher, friend, coach) and one employer is required

Name Relation Phone Number

Please reply to the following questions:

Why do you want to be an SCYC instructor and what do you feel you could bring to the program?

What are your strengths?

What are your weaknesses?

What kind of program and teaching experience are you looking for and what do you hope to gain from this experience?

I hereby certify that the above information is true and correct to the best of my knowledge and I understand that if hired, providing false information on this form is grounds for dismissal

Signature: type name to confirm or sign printed form Date: