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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
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School
Drop In
Agency
Other
Other
Have you Failed to be Reemployed, ever been involuntarily discharged, fired or asked to resign a position?
*
Yes
No
Give dates & circumstances