Volunteer Application Form - Ymca Of South Palm Beach County
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2YMCA of South Palm Beach County
VOLUNTEER APPLICATION
PERSONAL
Date:
(please give your FULL, LEGAL name)
Last Name
First Name
Middle Initial
Home Phone: (
)
___day ____evening
I prefer to be called:
Alternate Phone: (
)
___work___cell___other
Email Address:
Street Address:
Best time to reach you:
City, State, Zip:
Volunteer position you’re applying for:
Are you a YMCA Member?: Yes_____ Branch:
No_____
Other areas of interest:
Date of Birth:
___/___/___
Emergency Contact Name:
Relationship:
Phone number:
(Please list someone OUTSIDE your home – in the event of an emergency, we would automatically contact your home first, then this backup contact.)
Have you been convicted of, or plead guilty to, any criminal offense (other than a juvenile offense now expunged from your record) or released from prison in the
past ten years? Have you ever been convicted of, or plead guilty to, a felony?
Yes_____
No_____
If Yes, describe in full:
STUDENT VOLUNTEERS
Are you looking to fulfill a school requirement or will you receive school credit for your service?
Yes_____ No_____
IF YES, name of school:
Is this a Service-Learning experience? Yes_____ No_____
Number of Hours needed:
Deadline to Complete Hours:
COMMUNITY SERVICE VOLUNTEERS
RELATED BACKGROUND
Have you previously volunteered for or been employed by another YMCA? Yes_____
No_____
If Yes, please list all YMCAs and dates:
YMCA:
City, State:
Dates worked
AND/OR
Dates volunteered
1)
1)
1)
1)
2)
2)
2)
2)
Have you previously volunteered for other organizations: Yes ____
No ____ If yes, Organization name/duties: __________________________________
Current/most recent employer:
Location:
Position:
How long:
Current/most recently attended school:
Location:
Current year in school/highest level completed:
Date completed (or graduation date):
Certifications held (include date of expiration):
REFERENCES
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