YMCA Of Mount Vernon Employment Application

YMCA of Mount Vernon Employment Application
Thank you for your interest in the YMCA!

The YMCA is an equal opportunity employer and does not discriminate in recruitment, hiring or other terms or conditions of employment on the basis of race, color, religion, national origin, sex, disability, age or any other status protected by law.

If you would like to apply to join the YMCA staff team, please complete the application below.
- Be sure to write legibly
- The application must be completed in full
- Do not leave any spaces blank or write "see resume" in response to any question.
- Read and sign the last page of the application.
Position Applying For: (check all that you are interested in)*

Front DeskCleaning (must be 18)LifeguardSwim Lessons InstructorAdult Fitness InstructorGymnastics CoachChild WatchChild Care teacher (must be 18)Day CampInternship
Today's Date

MonthDayYear
Date
Date Available

MonthDayYear
Date
Name (First and Last)*
E mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Are you 18 year of age or older (if not, you will be required to get a work permit)

YesNo
Have you ever been convicted of a crime, pled no contest, or had adjudication withheld?

YesNo
If yes, please provide date and charges. (A conviction will not necessarily bar employment. The YMCA may consider the nature, date and circumstances of the offenses)
If hired, can you provide verification of your legal right to work in the United States?

YesNo
Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation?

YesNo
Notice to All Applicants: The YMCA enforces its policies and practices to prevent child 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 staff.
Employment/Volunteer Information

Please Mark all days and time you are available*

	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Times available

Preferred Job Status:

Full-timePart-timeSeasonalAs Needed
Have you previously been employed by this YMCA or another YMCA? Please explain in the other spot

YesNoOther
Have you previously volunteered at this YMCA or another YMCA? If yes, Please explain in the other spot

YesNoOther
Do you have relatives currently employed by the YMCA? If yes, please put name and relationship in the other spot.

YesNoOther
How did you hear about this opening?

YMCA staff referralSchoolWalk-inYMCA memberAdvertisementOther
If referred by a staff or member, Name of referral source

Education & Training

	Name of School	City, State	Diploma Awarded	Degree
High School
GED
College
Graduate School
Vocational/other

Describe any non employment experience such as school or volunteer activities that might strengthen your application
Please list any Safety & Job Specific Certifications (ie CPR, First Aid, CDA, etc)
List the past 3 previous employment starting with the most recent.
1. Past Employer Name
Address
Immediate Supervisor and Title
Phone Number
Please enter a valid phone number.
May we contact this employer

YesNo
Reason for Leaving
Beginning and Ending Wage
Dates employed
Summarize the nature of the work performed and job responsibilities.
2. Past Employer Name
Address
Immediate Supervisor and Title
Phone Number
Please enter a valid phone number.
May we contact this employer

YesNo
Reason for Leaving
Beginning and Ending Wage
Dates Employed
Summarize the nature of the work performed and job responsibilities.
3. Past Employer
Address
Immediate Supervisor and Title
Phone Number
Please enter a valid phone number.
May we contact this employer

YesNo
Reason for Leaving
Beginning and Ending Wage
Dates Employed
Summarize the nature of the work performed and job responsibilities.
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 postion
Personal References

Do no list relatives or past employers.
First Name    Last Name       Phone Number

Street Address       City       State Zip

Years Known            Occupation
First Name      Last Name          Phone Number

Street Address       City       State Zip

     Years Known   Occupation
Application Acknowledgement and Authorization

Please read all statements and sign below:

I authorize both the YMCA and persons listed (references, schools, current (unless noted) and former employers and any others with whom you desire to check) to communicate with regard to any relevant information that may be required to reach an employment decision. I agree to hold such persons harmless with respect to any information they may supply. I understand and agree that any offer of employment is contingent upon successful completion of all background check processes, including a criminal history background check.

I certify that all information provided by me in this application is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this application or any other document submitted in connection with YMCA employment will result in denial of employment or termination of employment regardless of the timing or circumstances of discovery.

If I am employed by the YMCA I understand my employment can be terminated, with or without cause and with or without notice, at any time at the option of the YMCA or myself. I understand that, other than the CEO of the YMCA, no manager, supervisor or representative of the YMCA has authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. Only the CEO of the YMCA has the authority to make any agreement contrary to the foregoing and then only in writing. I further expressly agree that, with respect to the at-will employment relationship, this constitutes the full, complete and final expression of the parties' intent concerning the nature of any employment relationship between myself and the YMCA.

I understand that all offers of employment are conditional upon my ability to provide appropriate documents regarding my identity and legal right to work in the United States. I understand that this application is only valid for the position applied for at present and that the YMCA is not obligated to retain or consider this application for future openings. If hired, I agree to abide by YMCA policies and rules at all times. I acknowledge that I have read the above statements and understand them.
Signature*

Clear
Date signed

MonthDayYear
Date
The Y: We're for youth development, healthy living, and social responsibility.
Should be Empty:

YMCA of Mount Vernon Employment Application

Personal References