Employment Application – Island of Hawaii YMCA

Application for Employment

We are an Equal Opportunity Employer. Applicants for all job openings are welcome and will be considered without regard to race, color, religion, national origin, sex, age, sexual orientation, physical or mental disability, ancestry, marital status, credit history, genetic history, or any other basis protected by state, federal or local law. It is the intent of the YMCA to comply with all applicable federal, state and local legislation concerning equal opportunity in employment. Notice to Applicants and Employees: The Island of Hawaii YMCA maintains a “Zero Tolerance” for abuse. This employment application is valid for a three-month period after submission to the Island of Hawaii YMCA. Consideration for employment after the three month period requires completion and submission of a new application. Applicants must have reliable transportation.

Name(Required)

Position(s) applying for:(Required)

*You may select multiple positions.

When are you available?(Required)

*Check all that apply.

Morning

Day

Evening

Weekend

Résumé

Max. file size: 5 MB.

Please upload your résumé here.

ID(Required)

Max. file size: 5 MB.

Please upload your ID here.

Please list any other names you have gone by, if applicable

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Number of years at address(Required)

Can you, after employment, submit verification of your legal right to work in the United States?(Required)

Yes

Employment Data

Please account for the last 10 years of employment history. Please list most recent employment first.

Company Name

Phone

Employment Start

Employment End

Job Title – Start

Job Title – End

Base Pay – Start

Base Pay – End

Supervisor Name & Title

Summarize the type of work performed / job experience:

Reason for leaving:

May we contact?

Yes

Later

Company Name

Phone

Employment Start

Employment End

Job Title – Start

Job Title – End

Base Pay – Start

Base Pay – End

Supervisor Name & Title

Summarize the type of work performed / job experience:

Reason for leaving:

May we contact?

Yes

Later

Company Name

Phone

Employment Start

Employment End

Job Title – Start

Job Title – End

Base Pay – Start

Base Pay – End

Supervisor Name & Title

Summarize the type of work performed / job experience:

Reason for leaving:

May we contact?

Yes

Later

Education and Training

High School(Required)

College(Required)

Degree Earned(Required)

Highest Degree Earned(Required)

Additional education, vocational or professional information such as special areas of research, study, seminars, etc.

Professional memberships, certificates, or licenses held. Please exlude those indicating race, color, religion, sex sexual orientation, national origin, age, physical or mental disability, or labor organization affiliation.

Computer skills, e.g. Microsoft Office, World, Excel, Outlook, etc.

References

Family Member Name

Relationship

Years Known

Phone

Former Supervisor

Relationship

Years Known

Phone

Professional / Personal

Relationship

Years Known

Phone

Professional / Personal

Relationship

Years Known

Phone

Current Certifications(Required)

CPR

First Aid

Lifeguard

Pre-Employment Checklist

Please read then type your initials to agree to the following statements.

I understand that this application is only valid for the position applied for at the present and that the YMCA is not obligated to retain or consider this application for future openings.(Required)

I understand upon contingent offer of employment, the Island of Hawaii YMCA will conduct a criminal background check prior to and during my employment as well as a child abuse registry check.(Required)

I am not a child molester, abuser, or pedophile; and have not been convicted of being a molester or abuser.(Required)

I authorize investigation of all statements contained in this application. I understand that falsification, misrepresentation or omission of facts called for will result in immediate termination from employment or removal of my application from consideration. I authorize the YMCA to secure information about my experience with former employers, education institutions and agencies, and for those parties to provide information concerning my experience releasing all parties from any liability arising there from.(Required)

If employed by the YMCA, I will abide by Association policies and rules. I understand that I will be required to possess a current and valid driver's license if my position requires me to drive in the course of my work. I further recognize that because the nature of the YMCA and its focus is youth, I am expected to be an appropriate role model, both on and off the job.(Required)

I agree to submit to legally permissible drug and/or alcohol testing upon request by the YMCA. I recognize that the results of these tests may be used to determine my continued employment. I understand and expressly agree that if employed by the YMCA storage areas provided for me (locker, desk, etc) are open to investigation by the YMCA without prior notice to me.(Required)

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 without liability.(Required)

Background Check Release of Information and Record

I hereby consent to an investigation by the Y into my personal history to determine my suitability for employment at the Y. I, therefore consent to the disclosure of any information contained in my private, public, or government files relevant to this application for employment regarding my past or present employment history.(Required)

I hereby consent to an investigation by the Y for a criminal background check. I understand that, by law, the Y will be looking at any or all (nothing over 10 years) criminal convictions that pertain to my employment with the Y.(Required)

I hereby release the Y and those associated with or acting on its behalf, and all employers, educational institutions, governmental agencies, individuals, and/or any other provider of information from any and all claims and/or liability in connection with said investigation and/or the provision of such information to the Y.(Required)

Last 4 Digits of Social Security Number(Required)

My signature below certifies that I have read and understand the foregoing and to the best of my knowledge and belief, the information on this form is true and correct. My signature below also certifies that I agree to be bound by the terms and conditions stated in this application. This application contains all the understandings and agreements between me and the YMCA concerning the nature of my employment, if any, by the YMCA and supercedes all prior and/or contemporaneous practices, oral or written agreements, understandings, statements, representations and promises, express or implied, between me and the YMCA.(Required)

Date of Application(Required)