Counselor In Training

Personal Information

Name

Birthdate

Mobile Phone

Home Phone

Parents/Guardian Information

Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Phone

Address Information

Address Line

Address Line 2

City

State

Zip Code

Education

Name of School

Grade

What extracurricular activities do you participate in? Which do you like best and why?

After submitting this application, please have both of your references email their letters of recommendation to Emily Brooks at the following email address: emily@warrencountyymca.org

More About Yourself

Why do you want to be a Counselor in Training (CIT)?

What are three personality characteristics you have that will help you to become a good CIT?

Consent

I understand and agree that if my service as a volunteer is accepted, there is no contract period for volunteer service and my volunteer service would be solely “at will,” giving either me or the YMCA the right to terminate my volunteer service at any time without liability or obligation.*