Goodwill Employment Application Page 3

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EMPLOYMENT HISTORY
CURRENT OR MOST RECENT EMPLOYER:
Employed from _________ to _________
Name of Employer: ______________________________
Starting Position: __________________
Street Address: _________________________________
Rate of Pay: $_______
 FT  PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________
Ending Position: __________________
Phone: (
)__________________________________
Rate of Pay: $_______
 FT  PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
NEXT PREVIOUS EMPLOYER ACTIVITY:
Employed from _________ to _________
Name of Employer: ______________________________
Starting Position: __________________
Street Address: _________________________________
Rate of Pay: $_______
 FT  PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________
Ending Position: __________________
Phone: (
)__________________________________
Rate of Pay: $_______
 FT  PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
NEXT PREVIOUS EMPLOYER ACTIVITY:
Employed from _________ to _________
Name of Employer: ______________________________
Starting Position: __________________
Street Address: _________________________________
Rate of Pay: $_______
 FT  PT
City, State, Zip: _________________________________
Name of Supervisor: _____________________________
Ending Position: __________________
Phone: (
)__________________________________
Rate of Pay: $_______
 FT  PT
Job Duties: ________________________________________________________________________
_________________________________________________________________________________
Reason for leaving: _________________________________________________________________
_________________________________________________________________________________
*FT = Full Time, PT = Part Time

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