Test Employment Application Employment Application - OLDER The YMCA is an equal opportunity employer. Discrimination because of race, creed, color, national origin, religion, gender, age or disability is prohibited. Date of Application* MM slash DD slash YYYY Name* First Last Phone*Email* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Select Location*Metropolitan OfficesC.W. Avery Family YMCAGalowich Family YMCAMorris Community YMCASmith Family YMCASelect Department*AquaticsFitnessMaintenanceMembershipSportsYouth & FamilyJoliet Y Jets Swim TeamOtherPosition Applying For*Availability* Part-Time Full-Time Unavailable to work certain days and hours Unavailable the following days and hoursHave you ever worked for the YMCA?*SelectNoYesIf yes, when and where?How did you hear about this job opportunity? YMCA Member YMCA Staff Social Media Advertisment Friend Other If you were referred by a YMCA employee, please list their name:Activities*List and describe any non-employment activities you have been engaged in that might strengthen your application. (i.e. service organizations, clubs, sports, clubs, hobbies, etc.) Work ExperienceInclude paid, volunteer and military service positions. Please begin with your most recent.Employer #1 (most recent)Employer #1 NameEmployer #1 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer #1 Contact Person or SupervisorEmployer #1 PhoneEmployer #1 Position TitleEmployer #1 Beginning SalaryEmployer #1 Ending SalaryEmployer #1 Start Date MM slash DD slash YYYY Employer #1 End Date MM slash DD slash YYYY Employer #1 Status Currently Employed Employer #1 Reason for Leaving Work ExperienceInclude paid, volunteer and military service positions. Please begin with your most recent.Employer #2Employer #2 NameEmployer #2 Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Employer #2 Contact Person or SupervisorEmployer #2 PhoneEmployer #2 Position TitleEmployer #2 Beginning SalaryEmployer #2 Ending SalaryEmployer #2 Start Date MM slash DD slash YYYY Employer #2 End Date MM slash DD slash YYYY Employer #2 Reason for Leaving ReferencesOne of the following references must be a family memberProfessional Reference #1 Name* First Last Professional Reference #1 Phone*Professional Reference #1 Relationship* Professional Reference #2 Name* First Last Professional Reference #2 Phone*Professional Reference #2 Relationship* Personal Reference #1 Name* First Last Personal Reference #1 Phone*Personal Reference #1 Relationship* Education & TrainingHigh School Name & Address*High School Dates Attended Month & Year*Did You Graduate High School?* Yes No College, Business or Trade School Name & AddressMajor Course or Degree ProgramDates Attended Month & YearDegree ReceivedOther Certifications & TrainingProvide type, dates and where it was obtained.Your ResumeUpload Your ResumeAccepted file types: doc, docx, pdf, rtf, Max. file size: 256 MB.File Types: doc,docx,pdf,rtf By Submitting This Form: I certify that all the above information is accurate to the best of my knowledge and belief and I understand that misrepresentation or omission of facts on this form is cause for disqualification for employment consideration or dismissal if hired. I understand that the contents of this application neither implies nor creates an employment contract. Employment at the Greater Joliet Area YMCA is “at will.” This means that employment may be terminated at any time with or without cause or notice by the employee or organization. I authorize the employers and references listed above to give the YMCA any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to the YMCA. I understand that employment is subject to completing other post-employment records and forms and providing documents which satisfy the requirements of the Immigration Reform and Control Act of 1986. I understand that the Greater Joliet Area YMCA is a drug and alcohol free environment and that employment approval is contingent upon passing a criminal background check. I hereby authorize investigation of all statements contained in this application and on the background check request. I understand that employment, should an employment offer be made, consists of a probationary period of 90 days. I understand that the YMCA requires a state of Illinois police background check on all persons offered a position at the YMCA and continued employment requires that the police report reflects that you have no felony conviction or evidence of criminal activity. NameThis field is for validation purposes and should be left unchanged.