Applicant Data Page 2
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4Goodwill Industries of Northern Michigan, Inc.
Application for Employment
Today’s Date:___________________Positions Applied For:_____________________________________
Name:_______________________________________________________________________________
Last
First
Middle
Telephone:__________________________ Alternate Telephone:_______________________________
Address______________________________________________________________________________
Number
Street
City
State
Zip Code
List any relatives or friends currently working at Goodwill______________________________________
____________________________________________________________________________________
Can you perform the essential functions of the position for which you are applying? ___Yes
___No
If necessary for the job, are you older than 18 years? ___Yes
___No
If necessary for the job can you provide a valid driver’s license without restrictions? ___Yes
___No
Are you legally eligible for employment in the United States?
___Yes
___No
Have you ever been convicted of a crime?
A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of
___Yes ___No
conviction, seriousness and nature of the crime, and rehabilitation will be considered.
If yes, please provide details (dates and location for all convictions)
_____________________________________________________________________________________
Have you ever been terminated from employment or asked to resign by an employer? ___Yes ___No
If yes, please provide details
_____________________________________________________________________________________
_____________________________________________________________________________________
Please indicate the date you will be able to begin employment__________________________________
Please indicate at which facilities you can work:
___Acme ___Alpena ___Cadillac ___Gaylord ___Goodwill Inn ___Petoskey ___ Paperworks Studio
___Traverse City Store ___Administrative Offices in Traverse City
Please indicate all types of schedules you are able to work
___Full-time(32+ hrs/wk) ___Part-time (less than 30 hrs/wk) __Casual(on call) ___Temp
Please indicate the days and hours of the week that you will work
Hours
Sunday
Monday
Tuesday
Wednesday Thursday
Friday
Saturday
From
To
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Parent category: Business