Complete all sections of the application and answer each question completely and accurately.


**NOTICE TO APPLICANTS**

The YMCA maintains a "Zero Tolerance" for child abuse and/or substance abuse.


Criminal Background check and other federal or state screenings for child abuse will be conducted. Screening tests for alcohol and illegal drug use may be required before and during volunteering.


The Hunterdon County YMCA is an equal opportunity employer. Prospective volunteers will receive consideration without discrimination based on race, creed, color,sex, age, national origin, handicap, veteran status or any condition prescribed by state or local law.


PLEASE NOTE: Incomplete applications cannot be processed. Please provide all information requested on the application and read the Statement of Applicant/Certification/Release carefully before you submit the application.



PERSONAL INFORMATION

Please include a phone number. If you have never been employed please fill out N/A under employer.



CRIMINAL HISTORY

Do you have any pending charges or have you ever pled guilty or been convicted of a crime, felony, disorderly persons offense, drunk driving offense or other violation of the law? Do not inlcude convictions that have been annulled, expunged or sealed by a court.

You MUST answer NO or YES in the box below. If yes, please explain & include dates, court name & location. (Pending charges or a conviction will not necessarily disqualify an applicant from volunteering but will be considered in relation to the position sought).



VOLUNTEER AREA

Please select your areas of volunteer interest from the list below:



SKILLS

Please select all volunteer skills from the list below:



T-SHIRT SIZE

Volunteers are occasionally provided t-shirts for their position. Please select your t-shirt size below:



DEMOGRAPHIC INFORMATION


AVAILABILITY


HOW WERE YOU REFERRED TO THE YMCA?


I PREFER TO BE CONTACTED BY


VOLUNTEER HISTORY

Please state previous volunteer experience with the Y or other organizations in the box below:



EMERGENCY CONTACT

You must include a phone number.



REFERENCES

Please provide three (3) references. One (1) MUST be a relative, but only one (1). You must include a phone number. YMCA staff members and YMCA volunteers are not able to serve as references. References must be at least 18 years of age.



STATEMENT OF APPLICANT/CERTIFICATION/RELEASE

In the Hunterdon County YMCA’s (hereafter referred to as HCYMCA) efforts to attract the highest quality volunteers, I have been advised that as a part of the application process for volunteer service with the HCYMCA, an extensive inquiry will be made concerning my prior employment, activities, character and health, and I fully consent to and authorize all such inquiries.


In the event of my volunteer service with the HCYMCA, I will comply with all policies set forth by the HCYMCA and with other policies established from time to time by the Association. I authorize the HCYMCA to request my employment record from any former employer(s). I further understand that inquiries may be made concerning my background, experience and prior employment. I hereby waive any right to claim that any request or investigation is an invasion of my privacy, since they are made with my consent and it is in my interest that I be considered for volunteer service. I understand that my continued volunteer service may be contingent upon a physician’s statement showing me to be in good health and a clean criminal history background check.


I understand that it is this Association’s option to secure conviction criminal history information as a part of the volunteer service screening process. I have provided the following information for the sole purpose of obtaining a criminal history file search. I understand that the HCYMCA does not condone child abusers and that, as a part of this investigation, the HCYMCA will be seeking information in my background related to child abuse.


I certify that all statements made by me on this application are true 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 volunteer service or, after serving as a volunteer, may be cause for termination of volunteer service with the HCYMCA.


I understand that the HCYMCA will take any allegations or suspicions of child abuse seriously and will report such allegations to the police and state agencies for investigation. I also understand that, if accepted as a HCYMCA volunteer, I am not allowed to fraternize with HCYMCA youth members or participants outside of HCYMCA programs, especially babysitting or inviting children to my home.


I understand that the HCYMCA follows the Character Development values of Caring, Honesty, Respect & Responsibility and that, if accepted as a volunteer, I will be expected to display and uphold these values during my volunteer service with the HCYMCA.


By signing this application, I certify that I have read and fully understand the questions asked in this application. I certify that the information provided by me is true, accurate and complete. I understand that any misrepresentation or omission of fact on this application or during any interview may preclude an offer of volunteer service, or may result in a withdrawal of an offer of volunteer service, or may result in my discharge from volunteer service if I am already volunteering at the time the misrepresentation or omission is uncovered.


I authorize investigation of all statements contained in this application. I authorize the HCYMCA (its authorized employees, agents or representatives)to secure information about my experience with former employers, education institutions, agencies, references and others and obtain informational reports including, but not limited to, criminal history and consumer reports. I release the HCYMCA (its authorized employees, agents or representatives) from any and all liability which might result from such investigation. I authorize former employers, education institutions, agencies, references and others to provide information concerning my experience and background, releasing all parties from any liability arising therefrom. I understand that, if accepted into volunteer service, my continued volunteer service is contingent upon the results of the investigation being acceptable in the sole discretion of the HCYMCA.

I authorize the HCYMCA to supply my volunteer record, in whole or in part, and in confidence to any prospective employer, government agency, or any other party, with a legal and proper interest.


I understand upon offer of volunteer service, the HCYMCA will conduct a criminal background check prior to and during my volunteer service as well as a child abuse registry check and I am subject to random, accident follow-up, and for cause drug testing as well as post offer drug screening contingent on volunteer service. I recognize that the result of these tests may be used to determine my volunteer service or continued volunteer service.

I am not a child molester, abuser or pedophile, and have not been accused of being a molester, abuser or pedophile.


I understand and expressly agree that, if accepted into volunteer service by the HCYMCA, storage areas provided for me (locker, desk, etc.) are open to investigation by the HCYMCA without prior notice to me.


I consent that photographs that may be taken of me by the HCYMCA are property of the HCYMCA and may be reproduced as the HCYMCA desires, free from any claim on my part.


I certify that, if accepted into volunteer service, there is no contract period for volunteer service and my volunteer service would be solely on "service at will" giving either me or the HCYMCA the right to terminate my volunteer status at any time for any reason without liability or obligation.


I understand that completion of this volunteer application does not guarantee me status as a volunteer unless I meet all stated minimum qualifications required of the volunteer position for which I am asking to be considered. I understand this application remains current for only 90 days. At the conclusion of this time, if I have not heard from the HCYMCA and still wish to be considered for volunteer service, it may be necessary to reapply and fill out a new application.


I certify that I have read the above statements and accept the same as a condition of my consideration for volunteer service with the HCYMCA.


I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THE ABOVE STATEMENTS AND THAT I VOLUNTARILY SIGN THIS APPLICATION.

*Signature is also required to be provided in person at the Y.