EDUCATION
High School or equivalent: (Please check highest year completed)
8
9
10
11
12
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 produce verification 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 a felony?
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: _________________
Name: ______________________ Relationship: _________________
Were you previously employed by this organization?
Yes
No
If yes,
Job title/location: _____________________/______________________
From: _____ _____ to _____ _____
mo
yr
mo
yr
Can you perform the essential functions of the job with or without reasonable
accommodation?
Yes
No