CAMP WAPSIE JOB APPLICATION 2024 JOB LISTING AND DESCRIPTIONS DATE Name STREET ADDRESS ADDRESS LINE 2 (if needed) CITY STATE ZIP Email PHONE WHAT POSITIONS ARE YOU APPLYING FOR? Food Services Director Health Services Director Junior Counselor (mid level counselor) Rotating Junior Counselor (entry level counselor) Senior Counselor ARE THERE ANY TIMES BETWEEN JUNE 1(MAY 28 FOR PROGRAM STAFF) AND JUNE 10 THAT YOU ARE UNAVAILBLE? PLEASE EXPLAIN FOR EACH POSITION YOU ARE APPLYING PLEASE WRITE 3-5 SENTENCES ON WHY YOU ARE APPLYING FOR THAT ROLE HAVE YOU EVER WORKED FOR A YMCA? Yes No IF SO WHICH YMCA? Relevant Skills, Training and/or Certifications AGE I am under the age of 16 I am over the age of 16 I am over the age of 18 I am over the age of 21 IF HIRED ARE YOU `ABLE TO PROVIDE LEGAL VERIFICATION OF YOUR RIGHT TO WORK? Yes No PLEASE LIST ANY FAMILY MEMBERS OR FRIENDS WHO WORK FOR THE YMCA AND THEIR RELATIONSHIP TO YOU. HOW DID YOU HEAR ABOUT THIS POSITION? Family Friend Social Media YMCA Employee Newspaper Job Site Listing Other REFERENCE #1 NON FAMIILY MEMBER NAME REFERENCE #1 PHONE REFERENCE #1 EMAIL REFERENCE #1 CITY, STATE REFERENCE #1 RELATIONSHIP TO YOU AND OCCUPATION REFERENCE #2 NON FAMIILY MEMBER NAME REFERENCE #2 PHONE REFERENCE #2 EMAIL REFERENCE #2 CITY, STATE REFERENCE #2 RELATIONSHIP TO YOU AND OCCUPATION HIGH SCHOOL NAME/CITY/STATE HIGH SCHOOL YEAR COMPLETED 9 10 11 12 COLLEGE ATTENDED (if applicable) COLLEGE ADDRESS CITY/STATE COLLEGE DEGREE (if applicable) OTHER CERTIFICATIONS OR DEGREE (Trades, License, Certification) IF YOU ARE CURRENTLY EMPLOYED PLEASE PROVIDE BACKGROUND ON YOUR EMPLOYER, POSITION AND HOW LONG YOU HAVE WORKED AT THIS EMPLOYER. UPLOAD RESUME IF AVAILABLE In the past 10 years, have you ever been discharged or suspended from employment for disciplinary reasons or have you been asked to resign? Yes No If YES please explain. Have you ever been convicted of a crime, had adjudication withheld, or pled no contest to a crime? No Yes If yes, please state the type of crime and the circumstances with regard to each including date of conviction, or plea and the penalty, if any imposed by the court. Have you ever been convicted or had any administrative finding of violating any law involving child abuse, sexual abuse, physical abuse, child endangerment, sexual harassment or exploitation or crime related to children? Yes No If yes, please state the type of crime and the circumstances with regard to each including date of conviction, or plea and the penalty, if any imposed by the court. Do you currently have any charges pending relating to any of the aforementioned? Yes No If yes, please explain. Why do you wish to work for Camp Wapsie?: Please describe your involvement within the community, volunteer groups and other organizations: If you feel there is additional information about yourself regarding your skills, experience, accomplishments, etc., that would assist us in evaluating your application, please share the details. I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand and agree that any misrepresentation or omission of facts would exclude my being considered for employment, or, after employment, would be cause for termination of employment with the YMCA of the Cedar Rapids Metropolitan Area (YMCA). I understand and agree that if I am employed, there is no contract period for employment, and my employment would be solely “employment at will”, giving either me or the YMCA the right to terminate my employment at any time without liability or obligation, except for my regular pay through date of termination. I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THE ABOVE STATEMENTS AND THAT I VOLUNTARILY SIGN THIS EMPLOYMENT APPLICATION. I understand and acknowledge the above: SUBMIT
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