Ymca Of Greater Springfield Volunteer Services Application
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3Lower Liberty Heights Outreach Center
Downtown Springfield Y Family Center
233 Franklin Street, Springfield, MA 01104
275 Chestnut Street, Springfield, MA 01104
(413) 206-5612
(413) 739-6951
Dunbar Y Family and Community Center
North End Outreach Center
33 Oak Street, Springfield, MA 01109
1772 Dwight Street, Springfield, MA 01104
(413) 788-6143
(413) 739-5820
Scantic Valley Y Family Center
Sullivan Outreach Center
45 Post Office Park, Wilbraham, MA 01095
160 Nursery Street, Springfield, MA 01101
(413) 596-2749
(413) 785-4721
Agawam YMCA Wellness & Program Family Center
Mason Square Outreach Center
63 Springfield Street, Agawam, MA 01001
33 Oak Street, Springfield, MA 01109
(413)-206-5653
(413) 788-6143
Downtown Springfield Outreach Center
Birch Park Outreach Center
275 Chestnut Street, Springfield, MA 01104
144 Birch Park Circle, West Springfield, MA 01089
(413) 739-6951
(413) 739-6597
VOLUNTEER SERVICES APPLICATION
NAME: ____________________________________________________________________________________________ DATE: ______________________________
ADDRESS: _______________________________________________________________________________________________________________________________
Street
City
State
Zip Code
TELEPHONE: HOME _______________________________________ BUSINESS ________________________________CELL _______________________
E-MAIL: _____________________________________________________________________________________ SEX: MALE __________ FEMALE ________
EDUCATION: ______ High School ______ College ______ Other
DATE OF BIRTH _______________________
VOLUNTEER CATEGORIES
YMCA Volunteer- Receives no special privileges or financial compensation.
Community Service - N/A
To fulfill requirements of an outside agency for benefits. {# of hours________ per ________.}
Intern - School credit _____________
Reason For Leaving: ___________________________________________________________________________________________
Have you volunteered for the YMCA before? If yes, what department? ___________________________
Have you volunteered for another organization? If yes, where? ____________________________________
Volunteer References
(Choose someone you recently worked for volunteered for, and someone you have known for many years)
Name
Title
Organization
Phone
1. __________________________________________________________________________________________________________________
2. __________________________________________________________________________________________________________________
Days And Times Available
Monday
Morning
Afternoon
Evening
Tuesday
Morning
Afternoon
Evening
Wednesday
Morning
Afternoon
Evening
Thursday
Morning
Afternoon
Evening
Friday
Morning
Afternoon
Evening
Saturday
Morning
Afternoon
Evening
PROGRAM AREAS YOU WOULD PREFER
(Please rate with 1 being your top choice(s) to 5 your least favorite.)
:
YOUTH-TEENS
HEALTH & RECREATION
OFFICE/OTHER
Aerobics
Day Care**
Clerical support
Active Older Adults (AOA) programs
Before/after school*
Fund-raising
Gym Monitor
Baby sitting/ Y Club
YMCA tour guide
Cybex Center equipment
Teen Center activities
Special Events
Swim lessons/Aquatics programs
Camp (in summer)
YSPEED
Adult sports
Youth sports (by season)
Specialty programs
(I.E., Photography,
Arts & Crafts)
**In order to volunteer in these program areas, a physician’s note stating that you are in good health
plus proof of vaccinations for measles, mumps and rubella is required.
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Parent category: Business