Application Form For Volunteer Page 3

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2011
What other organizations have you volunteered for, if any?
Are you a member of the YMCA? (Membership is not required) _______________________________
References
Please list three people other than relatives whom you have known for at least two years and who know you
well enough to provide us with a reference.
1. Name:
Address:
Telephone:
E-Mail:
Relationship to you:
How long have you known this reference?
2. Name:
Address:
Telephone:
E-Mail:
Relationship to you:
How long have you known this reference?
3. Name:
Address:
Telephone:
E-Mail:
Relationship to you:
How long have you known this reference?
Your Signature ____________________________________
Date: ____________
Parent or Guardian Signature _________________________
Date: ___________
(If under 18 years of age)

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