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 NameMiddle NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

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

Area CodePhone 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 CenterJCC Early Learning CenterLimestone Family Play ZoneBradford BranchBradford Early Learning CenterShinglehouse Early Learning CenterWellsville BranchWellsville Early Learning CenterOther
Volunteer Interest Areas*

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

MonthDayYear

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.
Today's date

MonthDayYear
Date
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