Application for Volunteer Service at the Palestine YMCA
PLEASE READ BEFORE COMPLETING THIS APPLICATION
This association does not discriminate in the recruitment and placement of volunteers on the basis of race, color, religion, national origin, sex, marital
status, age or veteran status. No question on this application is intended to secure information to be used in a discriminatory manner. Your completed
application will be reviewed carefully; but its receipt does not imply that you will be utilized. Volunteer consideration necessitates that you meet all
conditions required for the position for which you are applying.
Please Print Clearly
Today’s Date: ____________________ Position Volunteering: ____________________________________________
Name: ________________________________________________________________________________________
Address: _____________________________ City: ____________________ State: ________ Zip: _______________
Phone: Day: ____________________ Evening: ____________________ E-mail:______________________________
Emergency Contact:
Name: ________________________________________________________________________________________
Address: _____________________________ City: ____________________ State: ________ Zip: _______________
Phone: Day: ____________________ Evening: ____________________
Are you a member of a YMCA (membership is not required)? __________________
Do you have any of the following?
First Aid Certification
Expiration Date:_________
CPR Certification
Expiration Date:_________
Other Certification(s)
Expiration Date:_________
Explain: ___________________________
Interests
How did you learn about volunteer opportunities at the Palestine YMCA? _____________________________________
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Why would you like to volunteer? ____________________________________________________________________
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Have you heard about any particular volunteer opportunities that interest you? _________________________________
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Would you like to talk to someone further about what kinds of volunteer opportunities might match your skills, talents,
and interests? ___________________________________________________________________________________
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Are there any particular skills, talents, or interests you would like to share? ____________________________________
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What other organizations have you volunteered for, if any? ________________________________________________
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