YMCA of the Twin Tiers Job Application

Job Application

Please complete the form below to apply for a position with us.
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
Are you 18 years of age or older?
If you are under age 18, state your age
If you are under age 18, do you have working papers?

EDUCATION:

Rows	School name	School location	Years attended	Subjects studied or degree(s) obtained
High school
College
Trade/business school

U.S. MILITARY SERVICE: If you have served in the military, please provide the below information:

Rows	Branch	Rank	Number of Years of Service

REFERENCES: List the names of three references, 18 years or older, whom you have known at least one year, as well as one family member reference.

EMPLOYMENT HISTORY: List your last three employers, starting with your current/most recent first.

In order to be considered for employment opportunites with the YMCA of the Twin Tiers, you must read and agree to follow the follow policy. Click below to access the document:

YMCA of the Twin Tiers Child Abuse Prevention Policy and Code of Conduct
Signature: My signature confirms my acknowledgment and agreement to comply with these requirements. I understand that signing this form does not replace my responsibility to know and follow the Child Abuse Prevention Policy, Code of Conduct, applicable YMCA procedures, and applicable mandatory reporting laws.

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
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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