Volunteer Application
Please complete the form below to be considered for volunteer work at the YMCA of the Twin Tiers!
Full Name
*
First Name
Middle Name
Last Name
Any former names or aliases:
First 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
Are you 18 years of age or older?
*
Yes
No
If under age 18, state your age:
Have you ever been convicted of a crime?
*
Yes
No
If yes, please give details:
Are you currently listed on any state sex offender registry levels 1, 2, or 3?
*
Yes
No
Have you ever been investigated for abuse, misconduct, or boundary violations?
*
Yes
No
If yes, please explain:
Which branch(es) would you like to work in?
*
Olean Branch
Olean Early Learning Center
JCC Early Learning Center
Limestone Family Play Zone
Bradford Branch
Bradford Early Learning Center
Shinglehouse Early Learning Center
Wellsville Branch
Wellsville Early Learning Center
Other
Volunteer Interest Areas
*
Adult Sports
Child care
Aquatics
Membership Desk
Fitness Programs
Wellness Center
Pre-School Programs
Special Events
Youth & Family Programs
Coaching
Teen Activities
Office Duties
Maintenance
Other
Start date availability
*
-
Month
-
Day
Year
Hours available to volunteer
*
Rows
Start
End
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred number of hours to volunteer each week
*
Why do you want to volunteer for the YMCA?
*
Please list any previous volunteer experience (please note any experience working with children or vulnerable populations):
Are there any special considerations or restrictions on your volunteering? Please type yes or no. If yes, explain.
*
REFERENCES: List the names of three references, 18 years or older, whom you have known at least one year.
*
Rows
Name
Address
Phone
Years known
1. Reference 1
2. Reference 2
3. Family Member
Employment:
Rows
Employment Dates:
Name of Employer
Employer Address
Position
Reason for leaving
Job 1
Job 2
Job 3
Are you retired?
Yes
No
Have you ever been terminated or asked to resign from a position involving children or vulnerable persons?
*
Yes
No
If yes, please explain:
Education:
Rows
School Name
School Address
Years Attended
Subjects studied or degree(s) obtained
High School
College
Trade/Business School
Signature: I hereby acknowledge that I have read and understood the above statements, and that I voluntarily sign this application.
*
Today's date
-
Month
-
Day
Year
Date
Submit
Should be Empty: