Application Form



Personal Information

First Name*:
Middle Name:
Last Name*:
Present Address*:
City*:
State*:
Zip Code*:
Email*:
Home Phone*:
Mobile Phone:
Work Phone:

General Questions

Do you have a CDL?:
If yes, please describe the type:
Are you under 18 years of age?:
If under 18, if hired, can you furnish a work permit?*:
Why are you interested in working for Goodwill?:
What are the two (2) most important factors to you in choosing a job?*:
Have you been asked to resign or been terminated from a job in the last 5 years?*:
If yes, please explain (Response will not necessarily disqualify applicant; case by case):
Are you currently a student (or planning to go to school with the next 12 months?)*:
If yes, what impact does this have on your availability for work?:

Availability for Work

Do you access to transportation to and from work?*:
Are you legally eligible for employment in the United States?*:
Have you ever worked for Goodwill before?*:
If yes, please give dates & position:
Do you have any relatives employed by Goodwill?*:
If yes, please list relative(s) employed:
How were you informed of jobs at Goodwill?*:
If employee referral, please name:
Position Desired:
Salary Desired $:
When will you be available for work?*:
Hours Available?*:
Total Hours available per week?*:
Would you work Overtime when and as required?*:
Would you work:


Are you willing to relocate?:
Are there any other names you are known by for reference purposes?:
Please account for any gaps in your employment history:
What is the minimum number of hours you would consider acceptable per week?:
Are you currently Employed?*:
Is your intent to continue in your current job(s) if you work for Goodwill?*:
How many different employers have you worked for in the past five (5) years?*:
Have you ever worked in a retail store before?:
If yes, provide company and position held:
Do you have any commitments, vacation plans, scheduled activities that could affect your availability?*:
If yes, please note time and length of unavailability:
Do you hold any professional licenses?:
If yes, what types?:
Summarize special job-related skills and qualifications or experience:

Affirmative Action

Gender:
Ethnic Origin:
Are you a Veteran?:
Are you Disabled?:

Work Experience - * Please complete at least 1 Work Experience

Company Name:
Position/Title:
City:
State:
Start Date:
End Date:
Supervisor Name:
Supervisor Phone Number:
Please describe your job duties:
Please provide the reason for leaving:
Ok to contact:

Work Experience - * Please complete at least 1 Work Experience

Company Name:
Position/Title:
City:
State:
Start Date:
End Date:
Supervisor Name:
Supervisor Phone Number:
Please describe your job duties:
Please provide the reason for leaving:
Ok to contact:

Work Experience - * Please complete at least 1 Work Experience

Company Name:
Position/Title:
City:
State:
Start Date:
End Date:
Supervisor Name:
Supervisor Phone Number:
Please describe your job duties:
Please provide the reason for leaving:
Ok to contact:

Reference

CompanyName:
Name:
Relationship:
Phone:
email:

Reference

CompanyName:
Name:
Relationship:
Phone:
email:

Reference

CompanyName:
Name:
Relationship:
Phone:
email:

Education

Educational Institution:
City:
State:
Major:
Degree Earned:
Attended From:
Attended To:

Skills























































































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ACKNOWLEDGMENTS Please read the following statements carefully before signing.


Goodwill Industries of Delaware & Delaware County, Inc. will recruit, hire, train, and promote individuals, as well as administer any and all personnel actions, without regard to an individuals race, religion, creed, color, national origin, ancestry, disability, gender, age, marital status, sexual orientation, or other characteristics protected by law.  The organization will make reasonable accommodations to qualified individuals.  No question on this application is intended to secure information to be used for such discrimination.  Please advise us if any accommodations are required to assist you in the application process.


This application will remain active for 90 days.  After that period, if you still wish to be considered for future employment or another position with Goodwill Industries, another application must be submitted showing interest.  


1.    Conditional Offers:  All offers are contingent upon successful drug screening, reference and other background checks, and proof of authorization to legally work in the United States.


2.    References:  I authorize Goodwill Industries of Delaware & Delaware County, Inc. (Goodwill) to verify the accuracy of all representations on this application to contact any employer, person, or organization relevant to my application.  In addition, by signing below, I authorize these employers, people, and organizations to provide Goodwill with any information relevant to Goodwill’s employment decision.


3.    Drug Test:  I understand that all offers of employment by Goodwill are conditional upon the results of a drug test arranged and paid for by Goodwill.  I further understand that if the test result is positive, if I fail or refuse to provide specimen for analysis at the time requested, or if the specimen shows any signs of adulteration or substitution, the offer will be revoked, and will no be eligible for further employment consideration.


4.    Application:  I understand that nothing contained in this application, or the granting of an interview, is intended to create an employment contract between Goodwill and me.  No promises regarding employment have been made to me, and I understand that no such promises are binding upon Goodwill unless made in writing.


5.    Accuracy of Information:  I understand and agree that (a) the information I have provided is accurate to the best of my knowledge and subject to verification by Goodwill and (b) a material misrepresentation or deliberate omission of fact may be justification for refusal of employment or, if employed by Goodwill, dismissal.


6.   Conflict of Interest:  Goodwill policy restricts activities and relationships that create an actual or perceived conflict of interest with Goodwill’s businesses.  Such conflicts may affect a person’s employment or continued employment at Goodwill.  Failure to report potential conflicts may result in an offer not being made, an offer being rescinded, or corrective action, up to and including dismissal.


I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with Goodwill Industries of Delaware & Delaware County, Inc. is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause.  It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.