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?*

YesNo
If you are under age 18, state your age
If you are under age 18, do you have working papers?

YesNo
Can you, after employment, submit verification of your legal right to work in the United States?*

YesNo
You may be asked to submit to pre-employment drug and alcohol screening. Will you agree?*

YesNo
Have you ever been convicted of a felony, or for child abuse or sex-related crimes?*

YesNo
If yes, list dates and convictions*
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
Position(s) desired*

Child care, infant/preschoolChild care, school ageAquaticsMembershipFitness instructorWellness Center staff/personal trainerGymnasticsMaintenanceOther
Start date*

MonthDayYear
Date

Hours available to work*

EDUCATION:*

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

Rows	Branch	Rank

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

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

Were you ever employed by the YMCA?*

YesNo
If yes, in what position?
Association/branch name
Year of employment
Upload Resume

Upload a File

Cancelof
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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