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Employment Application

Please complete the above employment application and submit to the Chambersburg YMCA through the form below.

Personal Information

Contact Info

Military Service Data

Employment Information

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Education & Training

Employment History

Re-order Employer Job Title Immediate Supervisor and Job Title Reason for Leaving Dates Employed Hourly Rate/Salary Job Responsibilities May we contact this employer? Telephone Weight Operations
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Personal/Professional References

Application Acknowledgment and Authorization

I authorize both the YMCA and persons listed [references, schools, current (unless noted) and former employers and any others with whom you desire to check] to communicate with regard to any relevant information that may be required to reach an employment decision. I agree to hold such persons harmless with respect to any information they may supply. I understand and agree that any offer of employment is contingent upon successful completion of all background checks.

I certify that all information provided by me in this application is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation, or omission of any facts in this application or any other document submitted in connection with YMCA employment will result in denial of employment or termination of employment regardless of the timing or circumstances of discovery.

If I am employed by the YMCA I understand my employment can be terminated, with or without cause and with or without notice, at any time at the option of the YMCA or myself. I understand that, other than the CEO of the YMCA, no manager, supervisor or representative of the YMCA has authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. Only the CEO of the YMCA has the authority to make any agreement contrary to the foregoing and then only in writing. I further expressly agree that, with respect to the at-will employment relationship, this constitutes the full, complete and final expression of the parties intent concerning the nature of any employment relationship between myself and the YMCA.

If I am offered employment, I understand and agree that I may be required to undergo a physical examination and that my offer of employment will be conditional upon that examination. I agree to authorize release of all results or information obtained from such physical examinations. I agree to submit to legally permissible drug and/or alcohol testing upon request by the YMCA. I recognize that the results of these tests may be used to determine my employment or continued employment. I understand and expressly agree that if employed by the YMCA storage areas provided for me (locker, file cabinet, computer files, desk, etc.) are open to investigation by the YMCA without prior notice to me.

I understand that all offers of employment are conditional upon my ability to provide appropriate documents regarding my identity and legal right to work in the United States. I understand that this application is only valid for the position applied for at present and that the YMCA is not obligated to retain or consider this application for future openings. I understand that I will be required to possess a current and valid drivers license if my position requires me to drive in the course of my work. If hired, I agree to abide by YMCA policies and rules at all times. I acknowledge that I have read the above statements and understand them.
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