First Name
*
Last Name
*
Email
*
Phone
*
Do you hold a current Swim Teacher qualification?
*
Yes
No
Which Licence do you currently hold?
SCTA
AUSTSWIM
Royal Life Saving
Other
Do you have a valid Working With Children Check?
*
Yes
No
Do you have a current Education Department screening?
*
Yes
No
Do you have a current HLTAID009 CPR certificate?
*
Yes
No
What type of work are you interested in?
*
Regional WA
Perth Metro
Select all that apply
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