Employment If you are human, leave this field blank. Rappahannock YMCA Application Thank you for your interest in applying to the Rappahannock YMCA. This application should take 5-10 minutes, you will not be able to return to the application after you leave, please complete the application in its entirety in one sitting. Personal Data Date * First Name * Middle Name Last Name * Phone Number * Email Address * Current Address - Street * Current Address - City * Current Address - State * Current Address - Zip * Last Previous Address - Street * Last Previous Address - City * Last Previous Address - State * Last Previous Address-Zip * Number of Years at Other Address * Are You 18 Years of Age or Over? * Yes No Military Service * Yes No If Yes, Dates of Military Service Are You Authorized to Work in the United States? * Yes No Other Names Used During Prior Employment Other Names Used During Prior Employment General Position Type * Full-Time Part-Time Temporary (Seasonal) Acceptable Salary Range * Notice Required * Date Available * If Applying for Seasonal Work, Are You Available to Work During the School Term? Yes No Have You Previously Applied for Employment at Any YMCA? * Yes No Worked for Any YMCA? * Yes No If so, when? * Location? * How Were You Referred to the YMCA? * Employee Advertisement School Drop In Agency OtherOther Have you Failed to be Reemployed, ever been involuntarily discharged, fired or asked to resign a position? * Yes No Give dates & circumstances *
