Naugatuck Ymca Employment & Volunteer Application
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1
2IMPORTANT: Complete both sides
Naugatuck YMCA
EMPLOYMENT & VOLUNTEER
284 Church Street
Your application will be considered active for 30 days
Naugatuck, CT 06770
APPLICATION
(203) 729-9622
□
Check Box if Volunteer Application
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-
Name:
Social Security No:
Address:
Apt No:
City:
State:
Zip:
Email:
Home (
)
-
Cell (
)
-
Are you over 18?
If no, date of birth:
Have you ever worked at a YMCA before?
If yes, where?
AVAILABILITY
Hours Available
Total hours available
Are you legally able to
SUN
MON
TUE
WED
THU
FRI
SAT
per week
be employed in the US?
FROM
Position applied for
How did you hear
TO
of this job?
SCHOOL MOST RECENTLY ATTENDED
Address:
City:
State:
Name of School:
Did you
Sports/activities
graduate?
Still attending?
Degree:
while attending:
RECENT EMPLOYMENT – Please provide your employment history below. Additional sheets/resume may be attached if necessary.
1) Company:
Address:
City:
State:
Phone: (
)
-
Position:
Dates employed:
From:
To:
Supervisor:
Hourly rate:
Reason for leaving:
2) Company:
Address:
City:
State:
Phone: (
)
-
Position:
Dates employed:
From:
To:
Supervisor:
Hourly rate:
Reason for leaving:
3) Company:
Address:
City:
State:
Phone: (
)
-
Position:
Dates employed:
From:
To:
Supervisor:
Hourly rate:
Reason for leaving:
MILITARY SERVICE
Branch of Service:
Date enlisted:
Date discharged:
Highest Rank:
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