FAMILY CENTER

APPLY TODAY

Position(s) being applied for(Required)

Available Start Date(Required)

MM slash DD slash YYYY

For childcare, please state age group interested in working with

Location you are interested in working

Personal Details

Name(Required)

First Last

Date of Birth

MM slash DD slash YYYY

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Have you previously worked for any YMCA?(Required)

Yes

If yes, when + where?

Availability

Are you 18 years of age or older? If not, you will be required to furnish working papers upon hire(Required)

Yes

Can you provide legal documentation establishing your identity and eligibility to be legally employed in the United States?(Required)

Yes

What type of position are you applying for? Select all that apply(Required)

Full Time

Part Time

Seasonal

Other

When are you available? Select all that apply(Required)

Mornings

Days

Evenings

Late Evenings

Weekends

Certifications

Do you hold a current CPR Certification?(Required)

Yes

Expiration(Required)

MM slash DD slash YYYY

Do you hold a current First Aid Certification?(Required)

Yes

Expiration(Required)

MM slash DD slash YYYY

Do you hold a current lifeguarding Certification?(Required)

Yes

Expiration(Required)

MM slash DD slash YYYY

Employment History

Provide the following information of your past and current employers or assignments, starting with most recent.

Employer

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Starting Title

Final Title

Address

Phone Number

Reason for Leaving

Summarize they type of work performed and job responsibilities

Employer

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Starting Title

Final Title

Address

Phone Number

Reason for Leaving

Summarize they type of work performed and job responsibilities

Education/Volunteer History

School Name (High school, College, Trade)(Required)

Address(Required)

Major Course or Degree Program(Required)

Diploma/Degree Received(Required)

School Name (High school, College, Trade)

Address

Major Course or Degree Program

Diploma/Degree Received

School Name (High school, College, Trade)

Address

Major Course or Degree Program

Diploma/Degree Received

References

Please list at least four references/persons that know you well and can attest to your abilities and suitability for YMCA employment. One reference must be a family member.

Full Name(Required)

Phone Number(Required)

Relationship to you(Required)

Years known(Required)

Full Name(Required)

Phone Number(Required)

Relationship to you(Required)

Years known(Required)

Full Name(Required)

Phone Number(Required)

Relationship to you(Required)

Years known(Required)

Full Name(Required)

Phone Number(Required)

Relationship to you(Required)

Years known(Required)

Applicant Statement

Information Accuracy(Required)

I certify that all information I have provided in order to apply for and secure work with the YMCA is true, complete and correct, and I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the YMCA's service, whenever it is discovered.

Reference Request Approval(Required)

I expressly authorize, without reservation, the YMCA, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the YMCA, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations, organizations for furnishing such information about me. I am aware that I have the right to make a written request for disclosure of the nature and scope of any report that may be ordered.

Discrimination Statement(Required)

I understand that the YMCA does not discriminate in hiring or employment on the basis of race, color, veteran's status, religious creed, national origin, sex, ancestry, or age or on the basis of a handicap not limiting the applicant's ability to perform satisfactorily the job available. The YMCA will give this application every reasonable consideration. However, in accepting it, the YMCA makes no commitment of employment to the applicant.

Application Expiration(Required)

I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the YMCA and still wish to be considered for employment, it may be necessary to reapply and fill out a new application. Employment with the YMCA is employment at will which means that employees may end their employment at any time, for any reason and that the employer (the YMCA) may terminate employees at any time for any reason, with or without cause.

Identity and Proof of Work Status(Required)

I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I‐9 Form in this regard, and

Application Confirmation

I certify that I have read, fully understood and accept all terms of the foregoing Applicant Statement. Please enter your full name and todays date below.

Full name(Required)

Todays Date(Required)

MM slash DD slash YYYY

If you would like to submit a resume or cover letter please email Tammie Wageman at twageman@altavistaymca.com

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FAMILY CENTER

APPLY TODAY

Personal Details

Availability

Certifications

Employment History

Education/Volunteer History

References

Applicant Statement

Application Confirmation

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