Employment Application - Ymca Camp Soles (Page 4 of 4) in pdf

Personal References

Do not list relatives or past employers.

Name:

Relationship:

Years Known:

Address:

City:

State:

Zip:

E-mail:

Phone:

Alternate #: ______/____________

Name:

Position:

Years Known:

Address:

City:

State:

Zip:

E-mail:

Phone:

Alternate #: ______/____________

Name:

Position:

Years Known:

Address:

City:

State:

Zip:

E-mail:

Phone:

Alternate #:_______/____________

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 with regard to 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:

Date:

Employment Application - Ymca Camp Soles Page 4

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