Dear Volunteer:
At the Burbank Community YMCA, your time and talent go a long way. Every hour you spend as a YMCA
volunteer can have far-reaching results. The Y is more than a gym, it’s a cause dedicated to
youth development, healthy living and social responsibility. We couldn’t do all that we
do without the help of our many volunteers who consistently say that, they receive
much more than they give. The YMCA has a wide variety of volunteer opportunities to
match your passion, skills and schedule.
What can you be involved in?
• Providing the attention a child needs to develop.
• Encouraging positive behavior in teens.
• Supporting families so they can be successful and strong.
• Supporting a vibrant, thriving community.
• Serving as a role model for young people and a
companion for seniors.
• Encouraging healthier lives for people of all ages,
backgrounds, abilities and incomes.
Specifically—
As a YMCA volunteer, you can help with programs, lend a
hand in the office or at a special event, greet members as
an ambassador, or work on a committee. No matter how
you help, you will make a big difference as you work with
others to create a better community.
The Burbank Community YMCA needs more people like you. Thanks for helping us carry out our mission—
Providing people of all ages lifelong opportunities to become stronger in spirit, mind and body.
Sincerely,
April L. Houle
Director of Human Resources & Risk Management
BURBANK COMMUNITY YMCA
321 E. Magnolia Blvd, Burbank, CA 91502-1132
p 818.845.8551 f 818.845.0785 www.burbankymca.org
Burbank Community YMCA
Volunteer Application
VOLUNTEER TYPES
Please check the box for the volunteer opportunity that best fits your interest. You may check more
than one box.
Ongoing Volunteer


For those interested in being involved on a more ongoing basis.
Minimum 30 hours commitment over a minimum of one month period.
Administrative/Clerical
Gymnastic Program
Youth Flag Football
Youth & Government
Fitness
Stay and Play Room (babysitting)
Youth Basketball
Youth Soccer
Group Exercise
Welcome Greeter
Please indicate the number of hours you are interested in volunteering and time
frame:
Service Learning

For high school students needing to complete volunteer hours for school requirements
School Age program (K-5th grade)
Pre-school (18 months – 4 ½ years old)
10 hours only
More than 10 hours
Ongoing (50 or more hours)
Please indicate when hours must be completed by: _________________________
Special Events/Projects/Activities


We have a variety of special events throughout the year that require volunteer support.
Please complete Special Events one sheet in lieu of full application
We Love our Y fundraiser/camp barbeque
Y’s Service Club (Brochure available at
Membership Office)
Annual Support Campaign
Annual Turkey Trot fundraiser
Special projects (Please list any of the following skills you would like to offer in a voluntary capacity:
__ Clerical: Data entry, phones, copying, filing
__ Photography
__ Grant writing
__ Consulting (specify field)_______________
__ Electrical
__ Construction
__ Other:
Burbank Community YMCA
Volunteer Application
NAME:
BIRTHDATE:
LAST
HOME PHONE:
FIRST
CELL PHONE:
E-MAIL ADDRESS_
ADDRESS:
_
OVER 18? [Y] [N]
_
STREET
CITY
STATE
ZIP
EMPLOYER or SCHOOL:
HOW WOULD YOU LIKE TO BE CONTACTED? [
] PHONE [
] E-MAIL
ARE YOU A BURBANK COMMUNITY YMCA MEMBER? [Y] [N]
TELL US ABOUT YOURSELF: Why do you wish to volunteer at the Burbank Community YMCA and what particular
skills, talents or interests would you like to share?
REFERENCES: Please name 2 adults (not in your family) that have known you for at least 2 years and a phone
number and address where they can be reached.
Name
Phone
Years
Relationship
*Please note fingerprinting is mandatory for any volunteer 18 and older.
DO YOU HAVE ANY OF THE FOLLOWING?
First Aid Certification:
Expiration Date:
CPR Certification:
Expiration Date:
Other Certifications:
PLEASE FILL IN THE TIMES WHEN YOU ARE AVAILABLE TO VOLUNTEER:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
AM
PM
Thank you for your interest in volunteering. Please be aware that we do not trade out memberships or programs
in exchange for volunteering and volunteering does not necessarily lead to employment at the Burbank
Community YMCA.
I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY
KNOWLEDGE. I HEREBY AUTHORIZE THE BURBANK COMMUNITY YMCA TO ENGAGE IN A BACKGROUND CHECK
AND THE INVESTIGATIONS OF ALL STATEMENTS CONTAINED HEREIN INCLUDING THE REFERENCES LISTED
ABOVE, TO GIVE YOU ANY AND ALL PERTINENT INFORMATION THEY MAY HAVE. I HEREBY RELEASE ALL PARTIES
FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING THE INFORMATION DESCRIBED IN
THE PREVIOUS SENTENCE, TO THE BURBANK COMMUINITY YMCA.
APPLICANT SIGNATURE
DATE:
PARENT/GUARDIAN SIGNATURE
DATE:
(IF UNDER18 YEARS OF AGE)
FOR INTERVIEWERS USE ONLY
COMMENTS:
CHOSEN TO VOLUNTEER?
Y
N
IN WHAT CAPACITY:
INTERVIEWED BY:
DATE: