Goodwill Job Application Step 1 of 8 12% Personal informationName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Primary Phone*Secondary PhoneWork Phone Have you ever been employed with us?* Yes No Date* MM slash DD slash YYYY Where* Relatives that currently work for Goodwill: Where did you hear about the organization?:Are you available for part-time or full-time work?* Part-Time Full-Time How many hours can you work? :* Position desired: Pay desired: When will you be available to begin work?:* MM slash DD slash YYYY Are you legally eligible for employment in the United States?:* Yes No How did you learn of our organization?: Educational InformationCollege Name and the Location of the School(s)Course of Study: Did you Graduate?: Yes No Degree of Diploma: Highschool Name and the Location of the School(s)Course of Study: Did you Graduate?: Yes No Degree of Diploma: Elementary Name and the Location of the School(s)Course of Study: Did you Graduate?: Yes No Degree of Diploma: Other Name and the Location of the School(s)Course of Study: Did you Graduate?: Yes No Degree of Diploma:Other special training skills (language, machine operation, etc.):Membership of Professional of Civic Organizations Related to Position(s) for which applying (Exclude those with may disclose your race, color, religion or origin.)Goodwill Industries is an equal opportunity employer and does not discriminate in employment or hiring on the basis of race, color, national origin, sex, religion, disability, age, marital status, veteran status or any other legally protected status. Employment HistoryCompany Name* Company Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Hire Date* MM slash DD slash YYYY Termination Date Supervisor name* Salary at Hire* Salary at Termination* State Job Title and Describe Your Work:Reason for Leaving:May we contact the employers listed above?* Yes No Company 2Company Name* Company Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Hire Date* MM slash DD slash YYYY Termination Date* MM slash DD slash YYYY Supervisor name* Salary at Hire* Salary at Termination* State Job Title and Describe Your Work:Reason for Leaving:May we contact the employers listed above?* Yes No Company 3Company Name* Company Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Hire Date* MM slash DD slash YYYY Termination Date* MM slash DD slash YYYY Supervisor name* Salary at Hire* Salary at Termination* State Job Title and Describe Your Work:Reason for Leaving:May we contact the employers listed above?* Yes No Please explain any gaps in your employment history: References (Two should be work related and one may be friend or family)List References*NameTelephoneAddressRelationship Have you served in the U.S. Armed Forces?* Yes No MILITARYComplete this section if you served in the U.S. Armed ForcesBranch of Service: When did your Active Duty Begin? MM slash DD slash YYYY When did your Active Duty End? MM slash DD slash YYYY Describe your duties and any special training:Rank at Discharge: Date of Final Discharge: MM slash DD slash YYYY Applicants requesting driving position.Managers, Asst. Managers, Team Leaders, Truck DriversDo you have a valid driver's license?* Yes No License Details*StateLicense NoTypeExpiration DateDriving ExperiencePlease list commercial vehicles you have experience with driving.Please list any moving violations: BackgroundNote: Convictions are not necessarily a disqualifier of employment; however, failure to provide complete and accurate information in response to the following questions will result in denial or termination of employment, whenever discovered. In considering your conviction record, we will consider job-related factors including but not limited to the date and nature of the offense. Have you ever be convicted of a felony?* Yes No Please explain type of felony and date of conviction.*Have you ever been a defendant or identified as the wrongdoer in a civil action for alleged assault, battery or other type of intentional tort, such as alleged intentional injury to a person or property?* Yes No Please explain type of felony and date of conviction.*Some of our jobs require employees to spend extended periods of time on their feet and to perform such tasks as mopping floors, stooping, bending, lifting, pulling or pushing loads up to 50 pounds. After reading a job description, can you perform the duties of the job you are applying for with or without reasonable accommodation?* Yes No Applicant’s StatementPlease read carefullyI certify that the information I have provided to the foregoing questions is true and correct, and that no attempt has been made to conceal pertinent information. I authorize my former employers, schools and personal references to provide any information they may have regarding me, whether or not it is on their record. I hereby release them from all liability for divulging same. I understand that all statements made by me are subject to investigation by Goodwill, and that if any information given by me in this application is perceived to be false or misleading, I will be subject to dismissal at any time during the period of my employment, and I agree to hold Goodwill blameless in that event. If employment is obtained under this application, I will comply with all rules and regulations of Goodwill Industries of Southeast Texas, Inc. I understand that all employees of Goodwill are employees at will and, as such, are free to resign at any time without reason. Goodwill, likewise, retains the right to terminate an employee’s employment at any time with or without reason or notice. Nothing contained in the employee handbook or any other document provided to the employee is intended to be, nor should it be, construed as a guarantee that employment or any benefit will be continued for any period of time. Any salary figures provided to an employee in annual or monthly terms are stated for the sake of convenience or to facilitate comparisons and are not intended and do not create an employment contract for any specific period of time. I understand that if my work performance is perceived by company management to be substandard in any manner, at its discretion, management may or may not encourage me to improve my performance, and I hereby waive all expectations of such warning prior to termination. I specifically understand that very close attention will be given to my ability to precisely account for cash, inventory or other company assets entrusted to my care and further, that the natural and probable consequences of failure to precisely account for such cash, inventory or other assets on a daily basis, may be cause for termination of my employment and compensation without benefit of prior verbal or written warnings or counseling. If accepted for employment, I understand the use of illegal drugs is prohibited and that any offer of employment is conditional upon satisfactory results of any required drug test and background investigation. Goodwill Industries is an equal opportunity employer and does not discriminate in employment in regards to race, color, religion, sex, national origin, age, marital status, veteran status, disability or any other protected class as defined by federal, state or local statute. I understand and agree that if I should have a medical condition that may require reasonable accommodation at the workplace, it is my responsibility to inform the company of my need for and type of accommodation. This application is current for a period not to exceed (1) one year. At the conclusion of this time, if I have not heard from Goodwill and still wish to be considered for employment, it will be necessary for me to complete a new application. In the event of employment, I agree to comply with all other company policies, procedures, rules and regulations made known to me at the time of employment or any other times thereafter, and to perform all duties assigned to the best of my ability. I have read, understand and agree with the contents of the statement as the provisions had been my own. I certify that information contained in this application is true and complete.* Yes No CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
