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CYO Seasonal Worker Information
All St. Rose CYO seasonal workers must complete this form.
St. Rose CYO will be using the information you provide in this form as our primary way of contacting you and issuing payment. Be sure the email and cell number you provide are correct and accessible.
It is the seasonal workers' responsibility to notify St. Rose CYO (516-709-0260) if there are any changes to the information you submitted in this form (i.e., change of address, cell phone number change).
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* Indicates required question
Email
*
Your email
Primary Phone (cell preferred):
*
CYO's preferred method of contact for the distribution of work hours is TEXT.
Your answer
Secondary Phone (optional):
Your answer
Last Name:
*
Input Last Name as you want it to appear on your paycheck.
Your answer
First Name (Legal):
*
Input First Name as you want it to appear on your paycheck.
Your answer
Nickname (optional):
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Street Line 1:
*
Street Address, P.O.Box
Your answer
Street Line 2 (optional):
Apartment, Suite, Unit, Building, Floor
Your answer
City:
*
Massapequa
Massapequa Park
Other:
State:
*
New York
Other:
Zip Code:
*
11758
11762
Other:
Job Position
*
CYO work hours are dependent on the sports season in session. Potential work hours offered can be weekdays (Mon-Fri) from 6p-10p or weekends (Sat-Sun) from 9am-10p. You can select multiple jobs. CYO will contact you to inform you of your chosen position.
Referee (Certified Basketball) – Must be 18 years of age or older.
Referee (Non-Certified Basketball) – Must be 16 years of age or older.
Scorekeeper (Basketball/Volleyball) - Must be 13 years of age or older.
Venue Monitor – Must be 17 years of age or older.
All-Stars Counselor – Must be 16 years of age or older. Limited positions available.
Volleyball Counselor – Must be 16 years of age or older. Limited positions available.
Lifeguard – Must be 17 years of age or older and swim certified. Limited positions available.
Other - Do not check unless the CYO Office asks you to.
Required
Emergency Contact Name:
*
Your answer
Emergency Contact Phone:
*
Your answer
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