MetroWest YMCA Employment Application

Thank you for your interest in the YMCA!

We consider each application without regard to age, race, gender, color, religious creed, national origins, sexual orientation, criminal record, mental illness, handicap, disability, marital status or any other legally protected status pursuant to relevant federal, state and local laws. Reasonable accommodations will be made for applicants with disabilities and qualified new hires.

If you would like to join the YMCA staff team, please complete the application below.
•The application must be completed in full.
•Do not leave any spaces blank or type “see resume” in response to any question.
•Read and sign the last page of the application.

Position Applying For

Date

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone: Home

Please enter a valid phone number.Format: (000) 000-0000.

Telephone: Business

Please enter a valid phone number.Format: (000) 000-0000.

Telephone: Cell

Please enter a valid phone number.Format: (000) 000-0000.

Previous residence if less than (5) years

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If necessary, best time to call you at home is (include AM/PM)

YesNo

If yes, work number and best time to call (include AM/PM)

YesNo

NOTICE TO APPLICANTS: THE METROWEST YMCA MAINTAINS “ZERO TOLERANCE” FOR ABUSE.

Allegations or suspicions of child abuse are taken very seriously at the YMCA and will be reported to the proper authorities for investigation. We have abuse reporting procedures, there are unscheduled visits from supervisors, we have an open door for parents, and we have a code of conduct for staff. We minimize opportunities for abuse to occur and we talk with children about personal safety and touching limits. We also screen carefully to prevent abusers from being hired and we provide child abuse prevention training to all staff.

Screening tests for alcohol and illegal drug use may be required before hiring and during employment.

What department are you applying for?

Full Time (35-40 hours per week, 12 months)Part TimeSeasonal (FT or PT, less than 3 months)

Available start date?

Date

Any restrictions to work hours?

List available days/hours below, laying out each day Monday-Sunday.

YesNo

If yes, when and at which locations?

YesNo

If yes, when and at which locations?

YesNo

If yes, name(s) and relationship:

Name of referral source (if applicable):

Educational Background

Rows	Name of School	City, State	Diploma Awarded (Yes/No/In progress)	Degree	Major
High School/GED
College
Graduate School
Vocational/Other

Describe any non-employment experience such as school or volunteer activities that might strengthen your application:

Safety & Job Specific Certifications

Rows	Type (CPR, First Aid, Lifeguarding, etc)	Provider	Level	Expiration
Certification
Certification
Certification

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

Rows	Employer	Telephone	Address	Starting Job Title/Final Job Title	Immediate Supervisor and Title	Reason for leaving	Dates Employed (From, To)	Summarize the nature of the work performed and job responsibilities	May we contact this employer for a reference?
Employment History #1
Employment History #2
Employment History #3
Employment History #4

Please explain any gaps in your employment history:

What other business experience, personal experience or training have you had that may have prepared you for this position?

References: List 3 character references/persons that know you well and can attest to your abilities and suitability for YMCA employment (2 employment related- supervisor level- and 1 from a family member).

Rows	Name	Relationship	Years Known	Address	City	State	Zip	Email	Phone	Alternate #
Reference #1
Reference #2
Reference #3

I certify that all information I have provided in order to apply for and secure work with the MetroWest 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 MetroWest YMCA’s service, whenever it is discovered.

Initial

I expressly authorize, without reservation, the MetroWest 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, resumé 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.

Initial

I understand upon offer of employment, the YMCA will conduct a criminal background check including child abuse registry and sexual abuse registry checks prior to and during my employment and I am subject to random, accident follow-up, and for cause drug testing, as well as post offer drug screening contingent on employment.

Initial

I am not a child molester, abuser or pedophile; and have not been accused of being a molester or abuser.

Initial

I understand that the YMCA does not discriminate in hiring or employment on the basis of race, veteran’s status, religious creed, national origin, sexual orientation, gender identity, 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.

Initial

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.

Initial

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

I certify that I have read, fully understand and accept all terms of the foregoing applicant statement.

Signature

Date

MetroWest YMCA Employment Application

Personal Information

Employment Information

Education & Training

Employment History

Application Acknowledgment and Authorization