Application For Employment - Ymca Page 4
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CERTIFICATIONS
CERTIFICATION
TYPE (AUTHORITY)
CHAPTER
EXPIRATION DATE
Life guarding
WSI
First Aid
CPR
Other
Missoula Family YMCA Mission
The Missoula Family YMCA is dedicated to building a healthy spirit, mind, and body for each person it
serves. Through programs based on Christian principles, the YMCA helps strengthen families and build a
better community.
How do your personal standards of conduct relate to YMCA standards?
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Please list what contributions you feel you can make to the Missoula Family YMCA:
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REFERENCE DATA
PROFESSIONAL/WORK/PERSONAL (At Least one Personal) REFERENCES WE MAY CONTACT
Name
Address
Phone
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PRE-EMPLOYMENT CERTIFICATION
I understand that this application is only valid for the position applied for at present and that the YMCA is
(Initial)
not obligated to retain or consider this application for future openings.
I authorize investigation of all statements contained in this application. I understand that falsification,
(Initial)
misrepresentation or omission of facts called for will result in immediate termination from employment or removal of my
application from consideration. I authorize the YMCA to secure information about my experience with former employers,
education institutions and agencies, and for those parties to provide information concerning my experience releasing all
parties from any liability arising there from.
Missoula Family YMCA Employment Application Form
Revised-August 2014
pg.4
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