Employment Application

  • Personal History

  • MM slash DD slash YYYY
  • (A conviction record will not necessarily be a bar to your employment)
  • Education

  • Name of InstitutionLocationYears CompletedMajor/CoursesDid you Graduate/Degree 
  • Name of InstitutionLocationYears CompletedMajor/CoursesDid you Graduate/Degree 
  • Name of InstitutionLocationYears CompletedMajor/CoursesDid you Graduate/Degree 
  • Skills

  • Personal References

    (Not former employers or relatives)
  • Name and OccupationAddressPhone Number 
  • Name and OccupationAddressPhone Number 
  • Name and OccupationAddressPhone Number 
  • Volunteer Experience

    List volunteer positions held during the last three years which are relevant to this position.
  • Name, Address, Phone Number of Employer/Name of SupervisorDates From/ToPosition HeldReason for Leaving 
  • Name, Address, Phone Number of Employer/Name of SupervisorDates From/ToPosition HeldReason for Leaving 
  • Employment History

  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Name Address, Phone Number of Employer/Name of SupervisorDates From/ToPositionSalary/Hourly RateReason for Leaving 
  • Driver's License #Name of StateClassification 
  • The YWCA of Ulster County does not discriminate in hiring or employment on the basis of race, color, religion, national origin, sex, marital status, age or disability. No question on this application is intended to secure information to be used for discriminatory purposes. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. In processing this employment application, the YWCA of Ulster County reserves the right to contact pervious employers to verify employment history and personal references. I hereby acknowledge that I have read the foregoing disclosure and understand the same. I also affirm that my answers contained herein are tru and correct and that I have not knowingly withheld any facts or circumstances that would, if disclosed, affect my application.
  • MM slash DD slash YYYY