EMPLOYMENT APPLICATION

STERLING-ROCK FALLS FAMILY YMCA APPLICATION FOR EMPLOYMENT

We are an Equal Opportunity Employer. Applicants for all job openings are welcome and will be considered without regard to race, color, religion, national origin, sex, age, sexual orientation, physical or mental disability (other than where a bona-fide qualification exists), veteran status or any other basis protected by state, federal or local law. It is the intent of the YMCA to comply with all applicable federal, state and local legislation concerning equal opportunity in employment.

Name

Address

Cell Phone # & Provider

Home Telephone No.

Email Address

Are you over 16 years of age?

Yes No

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

Yes No

Date Available

Type of Employment

Full Time Part Time Seasonal

Are you presently employed?

Yes No

If yes, may we contact your present employer?

Yes No

Have you ever applied at the Sterling-Rock Falls YMCA before?

Yes No

If yes, when?

Have you ever been employed by the Sterling-Rock Falls YMCA before?

Yes No

If yes, when?

Please note your days/hours of availability:

High School

Years Attended From:

Years Attended To:

Level of Completion?

I am a Graduate I have earned my GED I am currently attending I am not currently attending

Field of Study

College/University

Years Attended From:

Years Attended To:

Level of Completion?

I am a Graduate I have earned my GED I am currently attending I am not currently attending

Degree held or Major?

Additional Education, Vocational and/or Professional Information. Please list any foreign language skills below.

Professional memberships, certificates or licenses held. (Exclude those indicating race, color, religion, sex, sexual orientation, national origin, age, physical or mental disability or labor organization affiliations.) Please provide a copy.

Computer Skills, i.e. Microsoft Office- Word, Excel, Outlook, etc.

Awards, Recognition:

Professional - Name

Profession

Phone

Professional - Name

Profession

Phone

Immediate Family Member - Name

Relationship

Phone

Company Name/Address

Phone

Description of Job Duties - Job Title-Start/Final

Base Rate of Pay Start

Base Rate of Pay Final

Dates of Employment

Supervisors Name

Company Name/Address

Phone

Description of Job Duties - Job Title-Start/Final

Base Rate of Pay Start

Base Rate of Pay Final

Dates of Employment

Supervisors Name

add attachment

I understand.

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.

I understand.

I understand that as a VOLUNTEER I am not covered under the Sterling-Rock Falls Family YMCA Workman’s Comp Insurance for any injuries I sustain during the time I volunteer at the YMCA. I understand that I am responsible for my own insurance coverage.

I understand.

Applicants selected for an interview and considered qualified will be subjected to a criminal background check. The results of any such criminal background check may disqualify the individual from employment opportunities, after discussion with the applicant. I understand that most felony convictions and criminal convictions involving children, violence, theft or sexual misconduct will automatically disqualify an applicant.

I understand.

I authorize investigation of all statements contained in this application. I understand that falsification, misrepresentation or omission of facts called for will result in immediate termination from employment or removal of my application from consideration. I authorize the YMCA to secure information about my experience with former employers, education institutions and agencies, and for those parties to provide information concerning my experience releasing all parties from any liability arising there from.

I give my authorization.

If employed by the YMCA I will abide by Association policies and rules. I understand that I will be required to possess a current and valid driver’s license if my position requires me to drive in the course of my work.

I understand.

If I am offered employment, I understand and agree that I may be required to undergo a physical examination at the YMCA’s expense and that my offer of employment may be conditioned by that examination. I agree to authorize release of all results or information obtained from such physical examinations.

I understand.

I agree to submit to legally permissible drug and/or alcohol testing upon request by the YMCA. I recognize that the results of these tests may be used to determine my employment or continued employment. I understand and expressly agree that if employed by the YMCA storage areas provided for me (locker, desk, etc.) are open to investigation by the YMCA without prior notice to me.

I agree.

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.

Digital Signature - By clicking on the submit button below certifies that I have read and understand the foregoing and to the best of my knowledge and belief, the information on this form is true and correct. This action also certifies that I agree to be bound by the terms and conditions stated in this application. This application contains all the understandings and agreements between me and the YMCA concerning the nature of my employment, if any, by the YMCA and supersedes all prior and/or contemporaneous practices, oral or written agreements, understandings, statements, representations and promises, express or implied, between me and the YMCA. I understand and agree that, except as noted above, no person who is either an agent or employee of the YMCA may modify, delete, vary or contradict, whether orally or in writing, the terms and conditions set forth herein.

By using this form you agree with the storage and handling of your data by this website.

Sterling-Rock Falls Family YMCA

STERLING-ROCK FALLS FAMILY YMCA APPLICATION FOR EMPLOYMENT

Sterling-Rock Falls Family YMCA

2505 YMCA Way Sterling, IL 61081

815-535-9622