<p> Surf City Yacht Club Application for Employment</p><p>Contact: Andrew Temme Application Date: 2/12/09 [email protected] 201-394-8799 </p><p>Please take the time to fill out the following information and respond to the questions. </p><p>Personal Information (type into form fields) Name: e-mail: Current/School Address: Permanent Address: Phone: (H) (C) (SCH) Date of Birth (mm/dd/yy) </p><p>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 </p><p>Education School Years Did you Major / Minor Name Attended Graduate? Secondary select select </p><p>High School select select </p><p>College select select </p><p>Other select select </p><p>Instruction Experience and History</p><p>Training: US Sailing Level 1 Date Certified US Sailing Level 2 Date Certified Other </p><p>Years of instruction experience as: Head Instructor / Coach Instructor </p><p>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 </p><p>Special Skills and Training</p><p>Please list any other skills and/or training you feel may apply to this position</p><p>Sailing and Power Boating Experience</p><p>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</p><p>Former Employers</p><p>Please list your former 3 employers starting with the most recent Dates Position & Club Supervisor Name & Salary Reason for Contact # leaving?</p><p>References List people that we may contact. At least one personal reference (teacher, friend, coach) and one employer is required</p><p>Name Relation Phone Number</p><p>Please reply to the following questions:</p><p>Why do you want to be an SCYC instructor and what do you feel you could bring to the program?</p><p>What are your strengths?</p><p>What are your weaknesses?</p><p>What kind of program and teaching experience are you looking for and what do you hope to gain from this experience?</p><p>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</p><p>Signature: type name to confirm or sign printed form Date: </p>