Employment

Note to all applicants: The YMCA enforces its policies and practices to prevent child abuse.

Allegations or suspicions of child abuse are taken very seriously at the YMCA and will be reported to the proper authorities for investigation. We have abuse reporting procedures, there are unscheduled visits from supervisors, we have an open door for parents, and we have a code of conduct for staff. We minimize opportunities for abuse to occur and we talk with children about personal safety and touching limits. We also screen carefully to prevent abusers from being hired and we provide child abuse prevention training to staff.

Personal Information

Position applying for *

Aquatic Director (Full-time)

Aquatics Coordinator/Swim Coach (Full-time)

Lifeguard (Part-time)

Youth Program Staff (Part-time)Youth Program Staff (Part-time)

Other

Date

Preferred YMCA location *

Date Available *

Name (Last, First, Middle Initial) *

Email

Address

City

State/Province

Zip/Postal

Country

Primary Phone Number *

Business Phone Number

Are you 18 years of age or older? (If not, you may be required to provide work authorization.) *

Yes

No

If hired, can you provide verification of your legal right to work in the United States? *

Yes

No

Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation? *

Yes

No

Have you ever been convicted of a crime, pled no contest, or had adjudication withheld? If yes, please provide a date location, charges and a complete explanation of all offenses. (A conviction will not necessarily bar employment. The YMCA may consider the nature, date and circumstances of the offenses.) *

Yes

No

Please explain

Employment Information

List available days/hours

Sunday *

Monday *

Tuesday *

Wednesday *

Thursday *

Friday *

Saturday *

Preferred job status *

Full-time

Part-time

Seasonal

As needed

Have you previously been employed by this YMCA or any other YMCA? *

Yes

No

If yes, when? At which location?

Have you previously volunteered at this YMCA or any other YMCA? *

Yes

No

If yes, when? At which location?

Do you have any relatives or household members currently working for this YMCA? *

Yes

No

If yes, name(s) and relationship

Name of referral source

Education & Training

High School/GED

High School or GED *

High School

GED

Name of School *

City, State *

Diploma Awarded *

Yes

No

In Progress

College

College *

Yes

No

Name of School *

City, State *

Diploma Awarded *

Yes

No

In Progress

Degree *

Major *

Graduate School

Graduate School *

Yes

No

Name of School *

City, State *

Diploma Awarded *

Yes

No

In Progress

Degree *

Major *

Vocational/Other

Vocational/Other *

Yes

No

Name of School *

City, State *

Diploma Awarded *

Yes

No

In Progress

Degree *

Major *

Describe any non-employment experience such as school or volunteer activities that might strengthen your application *

Safety & Job Specific Certifications (1)

Safety & Job Specific Certifications (2)

Safety & Job Specific Certifications (3)

Safety & Job Specific Certifications (4)

Employment History (1)

Employer *

Phone *

Address *

Address

City

State/Province

Zip/Postal

Country

Job Title *

Immediate Supervisor and Title *

Dates Employed: Start Date *

Dates Employed: End Date *

Starting Hourly Rate/Salary *

Ending Hourly Rate/Salary *

Summarize the nature of the work performed and job responsibilities *

Reason for leaving *

May we contact this employer? *

Yes

No

Employment History (2)

Employer *

Phone *

Address *

Address

City

State/Province

Zip/Postal

Country

Job Title *

Immediate Supervisor and Title *

Dates Employed: Start Date *

Dates Employed: End Date *

Starting Hourly Rate/Salary *

Ending Hourly Rate/Salary *

Summarize the nature of the work performed and job responsibilities *

Reason for leaving *

May we contact this employer? *

Yes

No

Employment History (3)

Employer *

Phone *

Address *

Address

City

State/Province

Zip/Postal

Country

Job Title *

Immediate Supervisor and Title *

Dates Employed: Start Date *

Dates Employed: End Date *

Starting Hourly Rate/Salary *

Ending Hourly Rate/Salary *

Summarize the nature of the work performed and job responsibilities *

Reason for leaving *

May we contact this employer? *

Yes

No

Employment History (4)

Employer *

Phone *

Address *

Address

City

State/Province

Zip/Postal

Country

Job Title *

Immediate Supervisor and Title *

Dates Employed: Start Date *

Dates Employed: End Date *

Starting Hourly Rate/Salary *

Ending Hourly Rate/Salary *

Summarize the nature of the work performed and job responsibilities *

Reason for leaving *

May we contact this employer? *

Yes

No

Please explain any gaps in your employment history *

What other business experience, personal experience or training have you had that may have prepared you for this position? *

References (1)

Do not list any relatives or past employers

Name of Personal Reference *

Occupation *

Years Known *

Address *

Address

City

State/Province

Zip/Postal

Country

Email *

Phone *

References (2)

Do not list any relatives or past employers

Name of Personal Reference *

Occupation *

Years Known *

Address *

Address

City

State/Province

Zip/Postal

Country

Email *

Phone *

References (3)

Do not list any relatives or past employers

Name of Personal Reference *

Occupation *

Years Known *

Address *

Address

City

State/Province

Zip/Postal

Country

Email *

Phone *

Application Acknowledgement and Authorization

Please read all statements and sign below: I authorize both the YMCA and persons listed (references, schools, current (unless noted) and former employers and any others with whom you desire to check) to communicate about any relevant information that may be required to reach an employment decision. I agree to hold such persons harmless with respect to any information they may supply. I understand and agree that any offer of employment is contingent upon successful completion of all background check processes, including a criminal history background check.

I certify that all information provided by me in this application is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this application or any other document submitted in connection with YMCA employment will result in denial of employment or termination of employment regardless of the timing or circumstances of discovery.

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 that all offers of employment are conditional upon my ability to provide appropriate documents regarding my identity and legal right to work in the United States. 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. If hired, I agree to abide by YMCA policies and rules at all times. I acknowledge that I have read the above statements and understand them.

Signature *

Clear

Date *

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Columbus Family YMCA
Columbus, Nebraska

Columbus Family YMCA
Columbus, Nebraska

Employment Form

Job Descriptions

Personal Information

Employment Information

Education & Training

High School/GED

College

Graduate School

Vocational/Other

Safety & Job Specific Certifications (1)

Safety & Job Specific Certifications (2)

Safety & Job Specific Certifications (3)

Safety & Job Specific Certifications (4)

Employment History (1)

Employment History (2)

Employment History (3)

Employment History (4)

References (1)

References (2)

References (3)

Application Acknowledgement and Authorization

Contact Information

Facility Hours

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