Fillable Printable Goodwill Application Form

Goodwill Application Form

GOODWILL INDUSTRIES

OF SACRAMENTO VALLEY & NORTHERN NEVADA, INC.

EMPLOYMENTAPPLICATION

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 orveteran status, the presence of a non-related medical condition or disability or any other

legallyprotected 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:___________________________________________________________________________________________

LastFirstMiddle

Please indicate other names used in previous employment or schooling:____________________________

Address: _________________________________________________________________________________________

StreetCityState Zip

Home Telephone:( )____________________Other Contact Number:( ) __________________

Work Telephone:( )____________________

Person’s Name: ____________________________

Position Desired:___________________Location Desired:__________________

Date Available for Employment:____________________Full-Time

Part-TimeSalary/Rate Desired: ___________

Where did you hear about this position?

Source: Source Name:

____

Morning Afternoon Evening Morning Afternoon Evening

Monday

Friday

Tuesday

Saturday

WednesdaySunday

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 produceverification 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 afelony?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: _________________

Were you previously employed by this organization?YesNo

If yes,

Job title/location: _____________________/______________________

From: _____ _____ to _____ _____

moyrmo 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 NAMEDATEBe 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

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