DO NOT Print This Application. Printed applications will NOT be accepted at the main office.

Employment Application: Part 1

Personal Information

Last name** First name**
Present address
City State Zip code
Permanent address
City State Zip code
Phone number**
Alt. contact information
Referred by**

Employment Desired

Position
Desired location
Date you can start
Salary desired
 
If you are currently employed, may we inquire of your present employer?
Yes
No
Are you currently employed with this Goodwill?
Yes
No
Have you ever applied to this company before?
Yes
No
If so, where?
If so, when?

Education and Training

Select highest grade completed
Did you graduate high school?
Yes
No
High school name
High school location

Additional Education (other than High School), Location, Course or Major Studies

Detail #1

Name
Credits completed (semester)
Credits completed (quarter)
Degree/certification received (type)
Degree/certification received (year)

Detail #2

Name
Credits completed (semester)
Credits completed (quarter)
Degree/certification received (type)
Degree/certification received (year)

Detail #3

Name
Credits completed (semester)
Credits completed (quarter)
Degree/certification received (type)
Degree/certification received (year)

Employment Record

Begin with most recent position. Include any military or volunteer service.

Employment history 1

Name
Address
Phone/Fax
Job title
Supervisor
Reason for leaving
Date employed
From
To
Hourly rate/salary
Starting
Final
Work performed:

Employment history 2

Name
Address
Phone/Fax
Job title
Supervisor
Reason for leaving
Date employed
From
To
Hourly rate/salary
Starting
Final
Work performed:

Employment history 3

Name
Address
Phone/Fax
Job title
Supervisor
Reason for leaving
Date employed
From
To
Hourly rate/salary
Starting
Final
Work performed:

Goodwill conducts a background check on all employees. A conviction record does not exclude you from employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. Goodwill is UNABLE to accept certain violent crimes or theft convictions due to the nature of our work.

Have you ever been convicted of a felony or misdemeanor?
Yes
No
If yes, please list the following: conviction, year, and county and state:

Availability

Number of hours you would prefer to work each week:

To help us consider you for a job that matches your availability, please tell us the earliest time and the latest time you can work each day. Keep in mind that our retail involves working evening and weekends 9am to 9pm plus opening and closing.

Day Earliest time Latest time
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

If hired, the hours you have listed will be taken into consideration in our scheduling process. If you have any conflicts, please list them:

Summarize special skills and qualifications acquired from employment or other experience. Also include any additional comments about your background or career objectives that would be helpful in evaluating your possibility of employment with our company

(Maximum characters: 255)
You have characters left.

Special Employment Notice to veterans with disabilities, Vietnam era veterans, and individuals with physical or mental disabilities

Refusal to provide this information will not jeopardize or adversely affect your consideration for employment. This information will be treated as confidential. Current law requires covered federal government contractors and subcontractors to take affirmative action to employ and advance in employment specified categories of qualified veterans and qualified individuals with disabilities.

If you are veteran meeting criteria below or have a physical or mental disability, you are invited to volunteer this information. The purpose is to provide information regarding proper placement and appropriate accommodation to enable you to perform the job to the best of your ability in a proper and safe manner.

Special Employment Notice
(please check one) 		Individual with a Disability
Veteran with a Disability
Vietnam Era Veteran
Campaign Badge Holder
Recently separated Veteran
No Answer

Note: Additional documentation may be requested to verify information.

By submitting this application, you agree to the following:

"I certify that the information given by me in this application is true and correct without omission of any kind. I acknowledge that if any of the answers or that if any of the information is not true, accurate, or complete, I may not be hired or if hired I may be discharged. I am aware Goodwill will investigate my background as a condition of employment. I hereby waive any privilege I have to such information, except as provided by law. I release from liability any person or organization providing requested information to Goodwill. I also agree to submit to a medical examination to include post offer employment and random drug screening as a condition of employment, if requested. I understand that nothing contained in this application or in the granting of an interview, and any company policies, procedures, or handbooks that I might receive, are intended to create an employment contract between the company and myself for employment or for the providing of any benefits. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the company unless made in writing by an authorized company representative. If an employment relationship is established, I understand I have the right to terminate my employment at any time with or without cause and the company retains an identical right."

You must click the COMPLETE APPLICATION button on the next page in order to submit your application.

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