Application For Employment Form 2015
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3Youngstown Area Goodwill Industries
2747 Belmont Avenue
Youngstown, Ohio 44505
(330) 759-7921
FAX: (330) 759-0678
APPLICATION FOR
TDD: (330) 759-8415
EMPLOYMENT
PERSONAL INFORMATION
DATE_________________
NAME__________________________________________________________________________________________________________
LAST
FIRST
MIDDLE
PRESENT ADDRESS____________________________________________________________________________________________
STREET
CITY
STATE
ZIP
PERMANENT ADDRESS_________________________________________________________________________________________
STREET
CITY
STATE
ZIP
PHONE NO. (
)_______________________________
AREA CODE
IF RELATED TO ANYONE IN OUR EMPLOY,
REFERRED
STATE NAME AND DEPARTMENT________________________________________ BY____________________________________
(OMIT NAME OF SPOUSE)
EMPLOYMENT DESIRED
DATE YOU
SALARY
POSITION________________________________________ CAN START____________________ DESIRED_____________________
YES
NO
ARE YOU AT LEAST 18 YEARS OLD?
YES
NO
ARE YOU EMPLOYED NOW?
IF SO, MAY WE CONTACT YOUR PRESENT EMPLOYER?
YES
NO
EVER APPLIED TO THIS COMPANY BEFORE?
YES
NO
WHERE?________________________ WHEN?____________________
EVER WORKED AT THIS COMPANY BEFORE?
YES
NO
WHERE?________________________ WHEN?____________________
LIST ANY SPECIAL SKILLS OR ABILITIES RELATED TO THE JOB APPLIED FOR:________________________________________________
________________________________________________________________________________________________________________
ARE YOU LEGALLY ENTITLED TO WORK IN THE UNITED STATES?
YES
NO
HOURS AVAILABLE TO WORK: (please fill out chart)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
From
To
YEARS
DID YOU
DEGREE OR
COURSE
EDUCATION
NAME & LOCATION OF SCHOOL
ATTENDED
GRADUATE
DIPLOMA
OF STUDY
YES
GRAMMAR
SCHOOL
NO
YES
HIGH
SCHOOL
NO
YES
COLLEGE
NO
TRADE, BUSINESS
YES
OR ANY ADDI-
NO
TIONAL EDUCATION
(CONTINUED ON OTHER SIDE)
; 9/13
Revised 11/12, Reviewed 11/12
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Parent category: Business