Job Application

Name*

Home Telephone*

Alt. Phone Number

Email*

Emergency Contact Name*

Emergency Contact Phone Number*

Address: Street, City, State, Zip*

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

Number of Years at Current Address*

Previous Address: Street, City, State, Zip

Number of Years at Previous Address

If hired, can you submit verification of your legal right to work in the U.S.?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

If yes, please explain.

Are you presently employed?*

Yes
No

If yes, may we contact your present or past employer?

Yes
No

Have you ever been employed by the Summerville Family YMCA before?*

Yes
No

If yes, when?

Have you ever been employed by another YMCA?*

Yes
No

How were you referred to the Summerville Family YMCA?*

If referred by an employee, please provide the name.

Type of Position Desired*

Date Available*

Desired Salary*

Branch Location Desired

What shift(s) are you available to work?

Name & Location of High School

Did you graduate?

Yes
No

Name & Location of College/University

Major/Area of Study

Did you graduate?

Yes
No

Highest Degree Earned

High School
Associates
Bachelors
Masters
Doctorate

Additional education, vocational and/or professional information such as areas of research, seminars, etc.

Professional memberships, certificates or licenses held. (Exclude those that indicate race, color, religion, sex, sexual orientation, national origin, age, physical or mental disability or labor affiliations. Supplemental information can be provided as an attachment)

Other Skills (Typing, Computer Skills, & Certifications) Please include expiration dates for certifications.

U.S. Military Service Branch

U.S. Military special training or skills

Most Recent Employer Name, Phone Number, Address **

Dates of Employment*

Job Title (Start & Final)*

Pay Rate (Start & Final)*

Supervisor Name & Title*

Description of Job Duties*

Previous Employer Name, Phone Number, Address

Job Title (Start & Final)

Dates of Employment

Pay Rate (Start & Final)

Supervisor Name & Title

Description of Job Duties

Professional Reference Name, Email and Phone*

In order to be eligible to work at the Summerville Family YMCA, you must be at least 15 years old. Are you at least 15 years old?*

Yes
No

PRE-EMPLOYMENT CERTIFICATION I understand that this application is valid for the position applied for at present only and that the Summerville Family YMCA is not obligated to retain or consider this application for future openings. I give permission for my written statements on this application to be verified. Falsification, misrepresentation or omission of any fact will result in the removal of my application from the job pool and/or termination of employment. If employed by the Summerville Family YMCA, I will abide by its policies and rules. I understand that I will be required to possess a valid driver’s license if my position requires me to drive in the course of my work. I understand that the Summerville Family YMCA is a drug-free work place and that I may be required to submit to a physical examination and/or a drug screen at the Summerville Family YMCA’s expense. I also understand that the results will be released to the Summerville Family YMCA. Failure to submit for testing and/or failure of test will result in termination. Accidents on the job require a drug screen. I understand that property in or on the premises of the Summerville Family YMCA such as desks or lockers are subject to subject to search without being notified. I understand that the Summerville Family YMCA participates in the Employment at Will Act, which means that the Summerville Family YMCA or me may terminate employment with or without cause at any time, with or without notice. Only the CEO or Branch Directors, have the right to make any other agreements and will do so in writing. My signature below certifies that I have read and understand the above statements and to the best of my knowledge, the information on this form is true and correct. My signature below also certifies that I agree to be bound by the terms and conditions stated in this application.*

Today's Date*

Form Verification

Aquatics

Personal Training

Sports

Health & Wellness

Child Development

About the Y

Membership Info

Y Locations

Join

Give

Contact Us

Application for Employment

Application for Employment

KEEP IN TOUCH WITH WHAT MATTERS TO YOU

Receive the Summerville Family YMCA newsletter with news, offers and special events. Sign Up Today!