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Youth Staff Application

Name

First Name

Last Name

Birthdate

mm/dd/yyyy

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

(###)

###

####

Team(s) you wish to join:

What do look forward to most about this position?

Are there any parts of the job description that you find challenging, but are willing to be trained in?

Please explain.

REFERENCES

Please list one (1) reference who you have known for at least one (1) year. Provide his/her complete email addresses and phone number. Reference will be contacted by phone or e-mail. The information furnished to us by your reference will remain strictly confidential.

Reference Name

First Name

Last Name

Relationship

Phone

(###)

###

####

Parent/Guardian's Name

Date

YYYY