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Rev. 1/2010Doing business in Tacoma, Lacey, Olympia, Centralia, Longview,Yakima, Selah, Ellensburg, Port Townsend, and Port Angeles
Date:Position Applied ForLocation:NameAddressCity State ZIP CodeTelephone: Home Cell OtherE-mail AddressWhen are you available for work?
(Check all that apply)
:
Monday-Friday
Saturday
Sunday
Daytime
EveningList any friends or relatives you have working hereHave you ever worked for Tacoma Goodwill?
Yes
No If yes, when?Can you verify your legal rights to work in the U.S. by providing a birth certificate/proof of U.S.citizenship, or employment authorization?
Yes
No
Human Resources Department714 South 27th StreetTacoma, WA 98409-8193
At Goodwill, we welcome people with diverse backgrounds, including persons with disabilities or other disadvantages. In fact a substantial portion of our employees have a disability and/or economic disadvantage and we strongly encourage such persons to apply.
APPLICATION FOR EMPLOYMENTTacoma Goodwill
Rev. 1/2010
Employment Record
Starting with you most recent employment, list your employment history. You may add additional pages in order to list your complete employment history.
All information requested should be complete to the extent possible.
1) Name of Company
City, StatePosition Held SupervisorDate Began Date Ended TelephoneBeg. Wage End Wage May we contact?
Yes
NoDutiesReason for Leaving
2) Name of Company
City, StatePosition Held SupervisorDate Began Date Ended TelephoneBeg. Wage End Wage May we contact?
Yes
NoDutiesReason for Leaving
3) Name of Company
City, StatePosition Held SupervisorDate Began Date Ended TelephoneBeg. Wage End Wage May we contact?
Yes
NoDutiesReason for Leaving
4) Name of Company
City, StatePosition Held SupervisorDate Began Date Ended TelephoneBeg. Wage End Wage May we contact?
Yes
NoDutiesReason for Leaving
Explain any time between jobs:
Rev. 1/2010
Education and Training
EducationLevelSchool Name City, State Course of StudyGraduate?Circle oneHigh School
Yes No
Business orTrade School
Yes No
College orUniversity
Yes No
GraduateSchool
Yes NoList any additional training and special skills
Application Certification
Please read carefully before signing.
Employment with Tacoma Goodwill Industries is at-will and may be terminated at any time for any reason withor without cause, with or without notice, by the employer or employee. I understand that no managementofficial is authorized to make any verbal assurance or promise of continued employment.
I certify that the information given by me to Tacoma Goodwill Industries is true and correct, and thatfalsification, misrepresentation, or omission on this application (or accompanying documents) mayresult in separation of employment.
I agree to provide identification and employability documents if I am hired.
NOTE: Tacoma Goodwill conducts a Criminal Background Check on EVERY potential employee.
I understand that employment with Tacoma Goodwill Industries may rely upon information received relating to myCRIMINAL BACKGROUND HISTORY and PRE-EMPLOYMENT DRUG SCREEN. I freely consent to a pre-employment drug screen as required by Tacoma Goodwill Industries in compliance with Goodwill's Drug-FreeWorkplace Policy. Failure to consent to, or an unsatisfactory result from, a pre-employment drug screen willimmediately discontinue my consideration for employment.I hereby authorize Tacoma Goodwill Industries to contact my former employers, educational institutions, andreferences to obtain and verify the accuracy of information contained on my application materials. I also herebyrelease from liability Tacoma Goodwill Industries and its representatives for seeking, gathering, and using suchinformation to make employment decisions and I also hereby release from liability all other persons ororganizations for providing such information.I represent and warrant that I have read and fully understand the foregoing, and that I seek employment atTacoma Goodwill Industries under these conditions.SignaturePrint Name Date
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