recruitment, hiring or conditions of employment on the basis of race, color, religion,
national origin, citizenship status, sex, marital status, disability, age or veteran
status or any other status protected by law.
If you would like to join our team, please complete the application below.
Be sure to write legibly.
The application must be completed in full.
Do not leave any spaces blank or write "see resume" in response
Personal Information
City/State/Zip:
Home Phone: Cell/Business Phone:
Email Address:
Can you perform the essential functions of the job for which you are applying, with or without
reasonable accommodation?
Yes No
Have you ever been discharged or asked to resign from a previous job? If yes, give dates and
circumstances.
Yes No
Have you ever been subject to a child or adult abuse investigation? If yes, please provide a date,
charge and general comment.
Yes No
Have you ever been convicted of a crime, pled no contest, or had adjudication withheld? If yes,
please provide a date, charge and general comment. (A conviction will not necessarily bar
employment. The Company may consider the nature, date and circumstances as to whether the
Yes No
STRENGTHENING THE FOUNDATION OF OUR COMMUNITY
Employment Application
offense is relevant to the duties of the position applied for.) Signature:...........................
Preferred Location(s) Date Available:
Thank you for your interest in the Central Wichita !
The YMCA Central Wichita is an equal opportunity employer. We do not discriminate in the
to any question. Read and sign the application
Address:
Name :
If hired, can we provide you a verification of legal right to work in the United States Yes No
Are you 18 years of age or older? (If not, May we provide you authorization to work. Yes No
Nationality: