Supplemental Questionnaire

	Placer County Human Resources Department

	#2023-11110-01
	Supplemental Questionnaire


Last Name	First Name

To be considered for employment as a Lifeguard, you need to complete an online application and submit proof of possession of the three required safety certifications listed in the Minimum Qualifications section of this bulletin. Proof of a Drivers License is not required.

Please provide copies of the required safety certifications through one of the following means:

Scan/photograph documents and upload files to your application
Email as an attachment to jobs@placer.ca.gov
US Mail or hand deliver to: Placer County Human Resources: Attn: Lifeguard Recruitment, 145 Fulweiler Avenue, Suite 200, Auburn, CA 95603

If you have yet to obtain the three required safety certifications but plan to do so this spring, please mention this in your application materials.

Are you 16 years of age or older? (required)

Yes No

Do you currently possess a valid American Red Cross Lifeguard Certificate or equivalent?

Yes No

Do you currently possess a valid Cardiopulmonary Resuscitation (CPR) Certificate or equivalent?

Yes No

Do you currently possess a valid Emergency Medical Services Authority (EMSA) First Aid Certificate or equivalent?

Yes No

Do you have previous lifeguarding experience?

Yes No

If yes, how many years? Please also include a brief description of the location and types of duties performed.

Applicants reporting a "no" response to items 2 - 4 above are still encouraged to apply but must obtain the required certifications prior to beginning employment.

Thank you for completing the examination portion of the application process. We encourage applicants to review their answers for accuracy prior to submitting.

Please Save & Continue to move forward to the next tab.

Be sure to select the "Submit" button once the application has been completed. You will receive confirmation that the application has been submitted.