Fillable Printable Goodwill Application Form
Fillable Printable Goodwill Application Form
Goodwill Application Form
GOODWILL INDUSTRIES
OF SACRAMENTO VALLEY & NORTHERN NEVADA, INC.
EMPLOYMENT APPLICATION
Goodwill Industries is an equal opportunity employer. Goodwill will not discriminate or tolerate
discrimination against any employee or applicant in any manner prohibited by law. Applicants are
considered for all positions without regard to disability, race, color, religion, sex, national origin, age,
marital or veteran status, the presence of a non-related medical condition or disability or any other
legally protected status.
This application must be filled out completely to be considered for employment. If you need help with
the application, please notify Human Resources at 916-395-9000. We gladly accept resumes,
however, you must fill out this application to be considered. You must submit a separate application for
each position for which you apply. Please type your name at the bottom of the application before
submitting.
Date of application: _____________________
PERSONAL & GENERAL INFORMATION
Name: ___________________________________________________________________________________________
Last First Middle
Please indicate other names used in previous employment or schooling: ____________________________
Address: _________________________________________________________________________________________
Street City State Zip
Home Telephone: ( )____________________ Other Contact Number: ( ) __________________
Work Telephone: ( )____________________
Person’s Name: ____________________________
Position Desired: ___________________ Location Desired: __________________
Date Available for Employment: ____________________ Full-Time
Part-Time Salary/Rate Desired: ___________
Where did you hear about this position?
Source: Source Name:
____
Morning Afternoon Evening Morning Afternoon Evening
Monday
Friday
Tuesday
Saturday
Wednesday Sunday
Thursday
AVAILABILITY FOR WORK
Work schedules will include day, evening and weekend hours based on the availability that you
indicate on this application. We expect all of our employees to work multiple evening shifts each week,
weekends and on certain holidays, as needed and determined by the store manager. Notify your
shifts you are able to work.
manager immediately if your availability for work hours/days changes. Please indicate
below
the
Choose Position
Choose County
Choose Date
Internet Website
EDUCATION
Do you have a High School Diploma or GED? Yes No
College/University/Other
City/State
Diploma
# Yrs
Degree
Major Area of Study
Can you, after employment, submit verification of your legal right to work
in the United States? Yes No
NOTICE: New employees are required to produce verification of their legal
right to work in the United States and present sufficient and genuine
documents relating to their identity.
If under 18, can you provide a work permit? Yes No
For positions requiring driving, do you have a current California Driver’s License? Yes No
Have you ever been convicted of a felony or misdemeanor or agreed to a court
settlement for a lesser crime after being charged with a felony? Yes No
NOTE: You will not be denied employment because of a conviction record
unless the offense conflicts with our goals, mission or is related to the job
for which you have applied.
If Yes, please explain. Provide date(s):
_______________________________________________________
Are you currently employed? Yes No
May we contact your present employer(s)? Yes No
Are any of your relatives currently employed at Goodwill Industries? Yes No
If Yes,
Name: ______________________ Relationship: _________________
Name: ______________________ Relationship: _________________
Were you previously employed by this organization? Yes No
If yes,
Job title/location: _____________________/______________________
From: _____ _____ to _____ _____
mo yr mo yr
Can you perform the essential functions of the job with or without reasonable
accommodation? Yes No
High School or equivalent: (Please check highest year completed) 8 9 10 11 12
*FT = Full Time, PT = Part Time
NEXT PREVIOUS EMPLOYER ACTIVITY: Employed from _________ to _________
Name of Employer: ______________________________ Starting Position: __________________
Street Address: _________________________________ Rate of Pay: $_______ FT PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________ Ending Position: __________________
Phone: ( )__________________________________ Rate of Pay: $_______ FT PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
NEXT PREVIOUS EMPLOYER ACTIVITY: Employed from _________ to _________
Name of Employer: ______________________________ Starting Position: __________________
Street Address: _________________________________ Rate of Pay: $_______ FT PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________ Ending Position: __________________
Phone: ( )__________________________________ Rate of Pay: $_______ FT PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
CURRENT OR MOST RECENT EMPLOYER: Employed from _________ to _________
Name of Employer: ______________________________ Starting Position: __________________
Street Address: _________________________________ Rate of Pay: $_______ FT PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________ Ending Position: __________________
Phone: ( )__________________________________ Rate of Pay: $_______ FT PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
EMPLOYMENT HISTORY
PHONE
CERTIFICATION: Please read carefully before agreeing.
Interview: I understand that submitting an application is not a guarantee of an interview. I understand
that if called for an interview, I will be asked to sign this application.
AT WILL Employment: Company Rules and Regulations. I understand that if accepted for
employment, I agree to abide by Goodwill Industries rules, regulations and policies. I understand that I
can resign at any time and for any or no reason, and that Goodwill Industries may release me at any time
and for any or no reason. I understand that this AT WILL status cannot be modified except by written
agreement signed specifically for that purpose by the President/CEO of the company.
Overtime: I may be required to work overtime hours or hours outside a normally scheduled workday
or workweek.
References: I authorize Goodwill Industries to communicate with former employers, school officials
and persons named as references whom I hereby release from any liabilities or damages whatsoever
resulting from exchanges of such information. I understand that reference responses are confidential
and not available for my inspection. I understand that employment is contingent upon satisfactory
verification of previous employment, clearance for criminal record, and provision of required work
eligibility documents.
Correct and Complete Information: To the best of my knowledge, the information and the
statements I have made in this application are correct and complete. I understand that if employed,
false information provided in this application may result in immediate termination.
I Agree
APPLICANT NAME DATE Be sure you have completed all sections of this
application. Incomplete applications will be
rejected. This application will be active for 90
_____________________________ ________ days. You may reapply after that time.
ADDRESS
COMPANY
TITLE
NAME
1)
2)
3)
EMPLOYMENT REFERENCES: Please list persons we may contact for business references.
ADDITIONAL INFORMATION
Please provide any additional information (experiences, skills, abilities and training) which may be
related to the job you are applying for. You should exclude information which would reveal racial,
ethnic, religious, sexual preference or political background or orientation.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Submit
