Exit this survey 2017 Shelbert Swim Academy Instructors Rehire Form This information must be submitted by December 5, 2016. If you have any questions, please contact Hope Walker at 815-520-9865 or HopeWalker@rockfordparkdistrict.org Question Title * 1. Please enter the information indicated below:By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected. First Name: Last Name: Email Address: Zip Code: Home Phone: Cell Phone: Question Title * 2. Date of Birth: Date: Date Question Title * 3. Choose location(s) that you will be working: Alpine Pool Sand Park Pool Question Title * 4. Uniform InformationIt is very important that you submit a swimsuit size. If you are not sure of your size, go to Runner's Image to determine correct size. Suit sizes are submitted to Runners Image in February and no additional swimsuit orders can be placed after that order. Please indicate the swimsuit size that you wear below: Female 28 Female 30 Female 32 Female 34 Female 36 Female 38 Female 40 Female 42 Male S Male M Male L Male XL Male XXL Question Title * Rashguard Size S M L XL XXL Thank you for completing the Learn to Swim Information. Done