Valparaiso Family Ymca Volunteer Application (Page 2 of 2) in pdf

Weekly [ ] (How many hours per week? ________)

Bi-Weekly [ ]

Monthly [ ]

Special Events [ ]

What days and times are you available for volunteer work?

Monday

AM___________PM____________

Friday

AM_____________PM_____________

Tuesday

AM___________PM____________

Saturday AM_____________PM_____________

Wednesday

AM___________PM____________

Sunday

AM_____________PM_____________

Thursday

AM___________PM____________

Which areas of volunteer service

interest you?

[ ] Fund Raising

[ ] Valparaiso Triathlon

[ ] Building Maintenance

[ ] Campaigns

[ ] Electrical

[ ] Office Work

[ ] Golf Outing

[ ] Plumbing

[ ] Public Relations

[ ] HVAC

[ ] Grant Writing or Research

[ ] Committee Work

[ ] Custodial

[ ] Programs

[ ] Carpentry

[ ] Office Work

[ ] International

[ ] Landscape

[ ] Mailings

[ ] Projects

[ ] Other

[ ] membership/Marketing

[ ] Senior Activities

[ ] Sports/Programs

[ ] Board Work

[ ] Wellness

[ ] Coach

[ ] Advisory Board

[ ] Wellness Center

[ ] Asst. Coach

[ ] Board of Directors

[ ] Youth Class Assistant

[ ] Martial Arts

[ ] Foundation Board

[ ] Youth Wellness Center

[ ] Tae Kwon Do

[ ] Group Exercise Instructor

[ ] Ju Jitsu

[ ] Youth programs

[ ] Toeido

[ ] Counselor

[ ] Skill/Hobby Instructor

[ ] Roller Skating Asst.

[ ] Tutor/Mentor

[ ] Basket Weaving

[ ] Adult League Scorekeeper

[ ] Child Watch

[ ] Watercolor/Oil

[ ] Market Day

[ ] Flower Arranging

[ ] Aquatics

[ ] Halloween Party

[ ] Other ________________

[ ] Instructor

[ ] Daddy Daughter Date Nite

[ ] Aqua Aerobics

[ ] Breakfast with Santa

[ ] Other Special Skills Not Listed

[ ] arthritis Classes

[ ] Adaptive Classes

[ ] ALLWays Learning Preschool

[ ] Slide Attendant

[ ] Classroom Teachers Asst.

[ ] 8-11 AM M-F

[ ] Ringing In Spring

[ ] Swim Asst.

[ ] Packet Stuffing

[ ] 9:45-11:15 Mondays

[ ] Packet Pick-up

[ ] 10:45-12:15 Mondays

[ ] Race Day Help

[ ] Facility tour Guide

Are you a YMCA member? ________________

If so, for how many years? ____________________

Have you ever been convicted of a misdemeanor or felony by any court of law including local, state, federal or military? No__ yes___

(Answering yes to this question does not automatically disqualify you for volunteering.) If yes, please explain the circumstances:

Misdemeanor? Yes ____ Explain________________________________________________________________________________

Felony? Yes ____ Explain ____________________________________________________________________________________

I understand that falsification, misrepresentation or omission of information requested in this application, related documents or oral interviews may

subject me to immediate termination of volunteer opportunities. It is my understanding that the YMCA will make an investigation of my personal

history and may verify all data given by me in connection with my volunteer application, which may include criminal convictions and other reports.

I authorize such investigation and the giving of any information requested by the YMCA and I release from liability any person or entity giving or

receiving any such information.

This application will remain active for 1 year. I understand that if I am still interested in volunteering thereafter, I must reapply and complete a new

application at that time.

Applicant's Signature _______________________________________________________________ Date ___________________________

Valparaiso Family Ymca Volunteer Application Page 2

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