EmailMe Form - YMCA of Calhoun County Application for Employment

PERSONAL INFORMATION

Name *

First Middle Last

Address *

Street Address City State / Province / Region Postal / Zip Code

How long have you been at your current address? *

Please list any other addresses of residence in the last 7 years.

Email Address *

Phone Number *

### - ### - ####

Are you under the age of 18? *

Yes

No

Are you eligible to work in the United States? *

Yes

No

Have you ever previously worked or volunteered at YMCA of Calhoun County? *

Yes

No

If yes, what dates did you work or volunteer for YMCA of Calhoun County?

If yes, what position did you have when working or volunteering at YMCA of Calhoun County?

Do you have any relatives currently employed by the YMCA of Calhoun County? *

Yes

No

POSITION & AVAILABILITY:

What position are you applying for? *

What interests you about this position? *

Tell us about your work experience. How does your experience make you a good fit for this position? *

What do you like most about your current job? *

What do you least enjoy about your current job? *

What shifts are you available to work? *

Are you applying for a full-time or part-time position? *

Full-Time

Part-Time

What date are you available to start work? *

MM / DD / YYYY

COMPLETE THIS SECTION IF YOU ARE APPLYING TO WORK WITH YOUTH. If not, skip to EMPLOYMENT HISTORY.

Why do you want to work with youth?

What age group or gender do you prefer to work with? Why?

What is your philosophy about discipline?

What do you do when you are upset or angry about something?

Other than through employment, how are you involved with youth?

List 3 strengths you have in working with youth.

List 3 challenges you have in working with youth.

EMPLOYMENT HISTORY

May we contact your present or previous employer? *

Yes

No

Most Recent Employer: *

Supervisor: *

Address: *

Phone Number *

### - ### - ####

Position: *

Duties & Responsibilities *

Salary *

If not salaried, input hourly rate.

Start Date *

MM / DD / YYYY

End Date *

MM / DD / YYYY

Reason For Leaving *

Previous Employer: *

Supervisor: *

Address: *

Phone Number *

### - ### - ####

Position: *

Duties & Responsibilities *

Salary *

If not salaried, input hourly rate.

Start Date *

MM / DD / YYYY

End Date *

MM / DD / YYYY

Reason For Leaving *

VOLUNTEER EXPERIENCE

Please list your volunteer experiences with non-profit organizations.

Most Recent Volunteer Organization

Duties at Most Recent Volunteer Organization

Dates of Most Recent Volunteer Experience

Contact Person at Most Recent Volunteer Organization

Phone Number for Contact at Most Recent Volunteer Organization

### - ### - ####

Additional Volunteer Organization

Duties at Additional Volunteer Organization

Dates of Additional Volunteer Experience

Contact Person at Additional Volunteer Organization

Phone Number for Contact at Additional Volunteer Organization

### - ### - ####

EDUCATIONAL HISTORY

School Name *

School Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Type of School *

Name of Program or Degree *

Program completion date *

Additional School Name

School Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Type of School

Name of Program or Degree

Program completion date

SKILLS

Please list specific skills or training. What knowledge or individual experiences do you have which will be an asset to the YMCA of Calhoun County?

Skills and Qualifications: Licenses, Skills, Training, Awards *

REFERENCES

Must include at least 2 professional and 1 personal/family. If this is your first job, professional references may include coaches, teachers, church leaders, etc.

1st Professional Reference Name *

1st Professional Reference Email Address *

1st Professional Phone Number *

2nd Professional Reference Name *

2nd Professional Email Address *

2nd Professional Reference
Phone Number *

Personal Reference Name *

Personal Reference Email Address *

Personal Reference Phone Number *

YMCA of Calhoun County appreciates your willingness to share your skills. Providing safe and secure programs for our members, youth and their families is of utmost importance to us. The information gathered in this application is designed to help us provide the highest quality programs for the people of our community.

This Y has zero tolerance for abuse and will not tolerate the mistreatment or abuse of members and youth/program participants. Any mistreatment or abuse by an employee or volunteer will result in disciplinary action, up to and including termination of employment or volunteer service and cooperation with law enforcement.

This Y takes every allegation of abuse or misconduct seriously and will fully cooperate with the authorities to investigate all cases of alleged abuse or misconduct. Employees and volunteers shall cooperate with any external investigation by outside authorities or internal investigation conducted by the organization or persons given investigative authority by the organization. An employee or volunteer's failure to cooperate with an investigation will result in disciplinary action up to and including termination of employment or dismissal from the organization.

You will be provided with an Employee Code of Conduct that more specifically explains the expectations of working or volunteering at the Y.

Please check each of the statements below to indicate your acknowledgment and acceptance. *

I declare that all statements contained in this application are true and that any misrepresentation or omission is cause for rejection of my application, or dismissal from my position.

I understand that I can withdraw from the application process at any time.

My signature indicates that I have read and understand the above. (Do not sign until you have read and checked the above statements.)

“I authorize all the schools, persons, and organizations named in this application to provide any information in their possession or knowledge to the agents of the YMCA, for use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release the YMCA, my former employers and all other persons from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure. I understand and agree that any misrepresentation or omission of facts, in this application, will be justification for refusal or terminating employment, regardless of the time elapsed before discovery. There will be no agreement, expressed or implied, between the YMCA and me for any specific period of employment, nor for continuing or long term employment, unless made in writing and signed by the President and CEO of the YMCA of Calhoun County."

Applicant Signature *

Type name for signature

Date *

MM / DD / YYYY