Clone of SAY Volunteer Application

Summit Area YMCA Volunteens Application

The VolunTeens program is a two-week summer experience designed for teens ages 13–17 who want to make a difference in their community while gaining real-world skills. Participants spend half the day volunteering at organizations in and around the community—such as the Summit YMCA, Berkeley Heights YMCA, Reeves-Reed Arboretum, Community FoodBank of New Jersey, Junior League Thrift Shop, Summit Free Public Library, and more! Through hands-on service, leadership activities, and team-building experiences, teens learn responsibility, communication, and the value of giving back. VolunTeens also explore different community sectors, meet local leaders, and work together on meaningful projects that strengthen our neighborhoods. This program is perfect for students looking to earn volunteer hours, build their resumes, develop leadership skills, and make new friends—all while having a fun, rewarding summer experience. A parent/guardian is required to complete and sign the application for minors under the age of 18.
VOLUNTEEN INFORMATION
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Phone Number*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*

FemaleMaleOther
Ethnic Origin*

WhiteBlack/African-AmericanNative Hawaiian/Pacific IslanderAsianAmerican Indian/Alaska NativeTwo or More RacesPrefer not to sayOther
Please note: Y-USA requests the above information from YMCA Volunteers throughout the nation for demographic purposes.

Parent Guardian Information
PARENT/GUARDIAN INFORMATION
Name*

First NameLast Name
Relationship to Minor*
Date of Birth*

MonthDayYear
Phone Number*
Parent/Guardian Email*
example@example.com
Do you want to provide Emergency Contact information that is different from the Parent/Guardian information provided above?*

Emergency Contact Information
EMERGENCY CONTACT INFORMATION
Name

First NameLast Name
Relationship to Volunteer
Phone Number

Volunteer Questionnaire
Are you a current member of the Summit Area YMCA?*

YesNo
Are you a previous volunteer for the Summit Area YMCA?*

YesNo
What year?
The Volunteens program runs for two weeks, from Monday, July 6th through Friday, July 17th. Are there any days during this period that you will be unable to attend?

Background Check Authorization
Background Check Acknowledgment

The Summit Area YMCA may obtain information about you from a consumer reporting agency for volunteer purposes. Thus, you may be the subject of a “consumer report” and/or an “investigative consumer report” which may include, but is not limited to: employment and education verifications; social security number verification; criminal and civil court records; personal interviews; driving records; and/or any other public records or any other information bearing on your character, general reputation, personal characteristics and trustworthiness. These reports may be obtained at any time after receipt of your authorization and, if you are selected, throughout your affiliation with the Summit Area YMCA. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. The report will be generated by campbackgroundchecks.com (1200 South Outer Road, Blue Springs, MO 64015, 816-228-5255) or another outside organization. The scope of this notice and authorization is all-encompassing, however, allowing The Summit Area YMCA to obtain from any outside organization all manner of consumer reports and investigative consumer reports now and, if you are selected, throughout your affiliation with The Summit Area YMCA to the extent permitted by law. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report. In compliance with the FCRA Article 613, an email address and mailing address is required by each applicant in order for campbackgroundchecks.com to be able to send a consumer copy of any criminal records returned.
Background Check Authorization*
Please confirm your full name, including a middle name if you have one:*

PrefixFirst NameMiddle NameLast NameSuffix
If you used any previous, alias or maiden names other than what was provided above, please enter it below:

PrefixFirst NameMiddle NameLast NameSuffix
Social Security No.*
List Your Previous Address (Within 5 years)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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 of other violation of law? Do not include convictions that have been annulled, expunged or sealed by a court.*

YesNo
Answering yes to the above question does not constitute an automatic bar to volunteering but will be considered in relation to the position sought.
Please explain:*

Member's Code of Conduct Agreement
Member's Code of Conduct Agreement*

Child Abuse Prevention Code of Conduct Agreement
Child Abuse Prevention Code of Conduct Agreement*
Child Abuse Prevention Code of Conduct Agreement*

Child Abuse Reporting Procedures
Child Abuse Reporting Procedures*

Confidentiality Agreement
Confidentiality Agreement*

Waiver & Release of Liability
Waiver & Release of Liability*

Coronavirus/COVID-19 Warning & Disclaimer
Coronavirus/COVID-19 Warning & Disclaimer*

Photo/Video/Audio Release Policy

Summit Area YMCA Volunteer Handbook

Volunteer Required Training
Volunteer Required Training*

Volunteer Application Agreement
Volunteer Application Agreement*
Volunteer Signature*

Clear
Use your finger or mouse to sign your name.
Parent/Guardian Signature*

Clear
Use your finger or mouse to sign your name.
Today's Date*
Should be Empty: