YMCA of the Sandhills Employment Application: SUMMER CAMP COUNSELOR
Mission Statement:
To put Christian principles into practice through programs that build healthy spirit, mind, and body for all people.
Email address *
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Department *
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Last Name *
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First Name *
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Middle Initial
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Street Address *
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City/ State/ Zip *
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Phone # HM & Cell *
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E-Mail *
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Are you 18 or older? *
If no, please provide DOB: (Date)
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Have you ever been convicted of any criminal offense *
If yes, please describe in full
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Education
High School (Name)
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Did you Graduate
College (Name)
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Did you Graduate?
No. of Years completed
Degree or Major
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Military
Complete this section if you have served in the United States Armed Forces
Branch of Service
Period of Duty/ From:
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To: (Date)
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Rank of Discharge
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Type of Discharge
If other than honorable please attach letter of explanation
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Skills
Certifications, Licenses, and Specialized Skills (List only if related to job. Provide expiration dates)
Certificates
Years of Experience
Skills/Licenses
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Office/ Software (please list)/Typing (WPM) Office Machines: (Please list)
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Employment History:
Please give accurate, complete full-time and part-time employment records. Start with present or most recent employer.
Company: 1
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Address/City/State/Zip:
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Name/Title of Supervisor:
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Describe Work:
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Phone #
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Employed from: (Date)
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To: (Date)
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Reason of Leaving
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Job Title
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Company 2
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Address/City/State/Zip
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Name/Title of Supervisor:
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Describe Work:
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Phone #
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Employed From: (Date)
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To: (Date)
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Reason for Leaving
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Job Title
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Volunteer Experience:
Volunteer work/membership in professional or civic organization related to this position
Organization, Length of Affiliation, Duties
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Organization, Length of Affiliation, Duties
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References
List names of those able to give references
1. Company, Organization:
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Phone #
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Relation to you
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2. Company, Organization
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Phone #
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Relation to you
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3. Company, Organization
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Phone #
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Relation to you
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How did you hear about us? *
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Disclaimer
I certify that my application is complete and accurate. Incomplete applications cannot be considered

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I also understand that the YMCA of the Sandhills is a drug free workplace and I may be required to submit to a pre-employment drug screening. If offered employment, I may be subject to random drug tests and I understand I must provide proof of my identity and legal right to work in the U.S. in compliance with the Immigration Reform and Control Act of 1986.
I understand that if an offer of employment is made, employment is seasonal. The YMCA of the Sandhills is an at-will employer and that either the YMCA or I may terminate the relationship at any time with or without cause or notice.

I further understand that, if I am employed, I am required to abide by all policies and procedures of YMCA of the Sandhills.

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