YMCA OF GREATER PROVIDENCE
APPLICATION FOR EMPLOYMENT
The YMCA of Greater Providence is committed to providing equal employment opportunity in all employment
practices. We prohibit unlawful discrimination based on race, color, religion, creed, sex, sexual orientation, age,
national origin, physical or mental disability, ancestry, gender identity or expression, or any other class protected by
federal, state, or local laws. The questions on this application are not intended to elicit information regarding
membership in any protected class. The YMCA will make reasonable accommodations to enable a qualified
individual with a disability to perform the essential functions of his or her job.
Today’s Date: _____/_____/_______
Name:
First
Middle
Last
Position for which you are applying:
YMCA Branch Location:
Circle your availability:
Part-Time
Full-time
Temporary
Seasonal
Your address:
E-Mail Address:
Home or Cell Phone Number:
Are you at least eighteen (18) years of age?
О yes
О no
Are you authorized to work in the United States?
О yes
О no
О unsure
***By law, an I-9 form must be completed by you within 72 hours of commencement of employment. ***
Please circle how you learned about the position for which you are applying:
YMCA Employee:
Walk in
Newspaper ad
Internet posting
YMCA Member/Volunteer
Job Fair
College Recruiting
Have you ever submitted an employment application to any branch of the YMCA of Greater Providence?
О yes
О no
If yes, when? _____________________________________________
__
Have you previously been employed by any branch of the YMCA of Greater Providence?
О yes
О no
Have you previously been employed by any YMCA?
О yes
О no
Do you have any relatives who are employed by any branch of the YMCA of Greater Providence?
О yes
О no
If yes, name? _________________________________________________
Will you need reasonable accommodations to participate in the selection procedures (i.e. job interview, written testing,
or job demonstration) or to perform the essential functions of the job for which you are applying??
О yes
О no
О unsure