Volunteer Application - Ymca Of Northwest Florida printable pdf download

YMCA OF NORTHWEST FLORIDA

VOLUNTEER APPLICATION

Name: ________________________________________________

Sex: _____ Age: _____

Address: ____________________________ City/State/Zip: ___________________________

Preferred Phone: ________________ Email address: _________________________________

Employer or School: ___________________________________________________________

Emergency Contact Name & Number: _____________________________________________

Why are you interested in volunteering at the YMCA? _________________________________

____________________________________________________________________________

Where would you like to volunteer?

___Downtown

___ Northeast

___ Pullum

___ off-site program: ________________

What type of volunteer work would you like to do? (check all that apply)

___ desk/clerical

___ child care

___ maintenance

___ landscaping/grounds

___ youth sports

___ fitness/wellness

___ fundraising

___ special events

What kind of time commitment are you able to make?

___ one-time/special event ___ set # of hrs/week (how many? ____ when? ___________)

___ flexible/open (please explain: _____________________________________________)

Please list three references who are not related to you:

Name: ______________________

Phone: ____________

Relationship: ______________

Name: ______________________

Phone: ____________

Relationship: ______________

Name: ______________________

Phone: ____________

Relationship: ______________

Have you ever been convicted of a felony? _____ If yes, please explain: __________________

____________________________________________________________________________

I would like to volunteer for the YMCA and give permission for the YMCA to conduct the necessary

background checks on me to protect Y members and participants. I also certify that I am in normal

health and capable of participating as a volunteer with the YMCA. I also understand that the YMCA

reserves the right to discipline, suspend, or dismiss any volunteer for actions that conflict with YMCA

values.

To the best of my knowledge, the information I have provided is accurate and correct. I understand that

supplying false information about a criminal record is a misdemeanor punishable by law. I also

understand that a criminal record will not necessarily prevent me from volunteering.

Signature _______________________________

Date __________________

Signature of parent/guardian (if under 18) ______________________________

Volunteer 6-1-11

Volunteer Application - Ymca Of Northwest Florida

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