YMCA of the Twin Tiers Volunteer Application

Volunteer Application

Please complete the form below to become a volunteer at the YMCA of the Twin Tiers.
Full Name*

First Name Middle Name Last Name
Current Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number*

Area Code Phone Number
Have you ever been convicted of a crime?*

YesNo
If yes, please give details*
Are you currently listed on any state sex offender registry levels 1, 2, or 3?*

YesNo
Which branch(es) would you like to work in?*

Olean BranchOlean Early Learning CenterBradford BranchBradford Early Learning CenterWellsville Branch
Volunteer Interest Areas*

Adult SportsChild careAquaticsMembership DeskFitness ProgramsWellness CenterPre-School ProgramsSpecial EventsYouth & Family ProgramsCoachingTeen ActivitiesOffice DutiesMaintenance
Start date*

MonthDay Year
Date

Hours available to volunteer*

Preferred number of hours to volunteer each week*
My reason for volunteering?*
Are there any special considerations or restrictions on your volunteering? Please type yes or no. If yes, explain.*

REFERENCES: Give the names of three references, 18 years or older, whom you have known at least one year. *

Signature: I hereby acknowledge that I have read and understood the above statements, and that I voluntarily sign this application.

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Today's date

MonthDay Year
Date
The YMCA is an equal opportunity employment company. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color, age, sex, religion, national origin, disability, marital status, or arrest record. As an employer, we will try to reasonably accommodate employees with religious beliefs.
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