Application for Employment

In every aspect of our work we seek to create an environment that encourages and promotes moral and ethical behavior. All employees are expected to contribute to creating and maintaining such an environment. To be considered, each item must be completed.

THE WALLA WALLA YMCA IS AN EQUAL OPPORTUNITY EMPLOYER

This association does not discriminate in hiring or employment on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, non-job related medical condition or handicap, veteran, marital status or any other legally protected status. No question in this form is intended to secure information to be used for such discrimination. Please contact Human Resources if you require accommodation to complete the application or interview process.

Contact Information

Full Legal Name

Preferred Name or Nickname

Today's Date

Phone

Street Address

City

State

Zip Code

Position Applied For

Type of Position

Date you can start

Wage Period

Wage Amount Desired

Would you accept morning, afternoon, evening or weekend shift hours?

Which shift is most acceptable?

Personal Data

Are you at least 18 years of age?

(If no, employment is subject to verification that you are minimum legal age.)

Are you legally authorized to work in the US?

(Under the Immigration Reform and Control Act of 1986, all persons hired in the United States must provide documentation confirming identity and employment eligibility. Will you be able to provide proof of identity and U.S. citizenship or an alien registration number and a visa permitting work in this country if hired?)

Educational and Training Background

Indicate Highest Education Level

Did you graduate?

Name of High School

College Information

Name of College

College Major

College Minor

Graduate Work (if applicable)

Employment History

Have you worked for this YMCA previously?

Please list the postions, and dates of employment below.

THE WALLA WALLA YMCA IS AN AT-WILL EMPLOYER

Employment with the Walla Walla YMCA is voluntarily entered into, and the employee is free to resign at will at any time, with or without cause.

Similarly, the Walla Walla YMCA may terminate the employment relationship at will at any time, with or without notice or cause, subject to the provisions of applicable federal or state law.

Previous Employers

Company Name, Address & Type	Employed From	Employed To	Reason for Leaving	Supervisor's Name
Company Name, Addr, Type 1	From 1	To 1	Reason for Leaving 1	Supervisor's Name 1
Company Name, Addr, Type 2	From 2	To 2	Reason for Leaving 2	Supervisor's Name 2
Company Name, Addr, Type 3	From 3	To 3	Reason for Leaving 3	Supervisor's Name 3

May we contact the employers listed above?

If no, please explain

In addition to the positions identified above, list any other applicable skills:

References

Name	Address	Business or Occupation	Phone
Name 1	Address 1	Business or Occupation 1	Phone 1
Name 2	Address 2	Business or Occupation 2	Phone 2
Name 3	Address 3	Business or Occupation 3	Phone 3

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PLEASE READ CAREFULLY BEFORE SIGNING:

I attest that the information provided in this application is true and correct and agree that any untruthful or misleading answers, or omission offact, may result in rejection of this application, or dismissal if employed. I authorize and release any and all former employers, supervisors, andany other persons to furnish the YMCA with information concerning my work performance, skills, abilities, and character.
I understand that if an offer of employment is made, employment is conditional based upon the results of background investigation(s) conductedby the YMCA. Background investigations include completion of a criminal conviction and abuse/exploitation disclosure(s) and related recordscheck. Additionally, previous work experience, academic history, certifications, professional licenses, etc., may be verified.
If employed, I agree that employment with the YMCA is at-will and that either the YMCA or I may terminate the relationship at anytime with orwithout cause or notice. This at-will employment relationship can only be altered in writing signed by the CEO and me.
As a drug-free workplace I understand that if offered a position I may be required to submit to a pre-employment and/or random drug screening.I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of testing will result in withdrawal ofany employment offer or termination of employment if already employed.
I further understand that, if I am employed, I am required to abide by all policies and procedures of the Walla Walla YMCA.

Applicant Signature

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