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Job Application

Title: JOB COACH – FULL TIME

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name *
Last Name *
Email Address *

Contact Details

Address *
City *
Zip *
State *
Phone *
Cell phone

General Information

How did you learn about the current job opening? *
Have you filed an application with us before? *
If yes, give date:
Have you ever been employeed with us before? *
If yes, give date and position(s):
If you are under 18 years of age, can you provide required proof of eligility?
Are you currently on layoff status and subject to recall? *
When would you be available for employment?
Are you available to work:
Are you available to work nights?
Are you available to work Saturdays and Sundays?
Can you travel locally if a job requires it?
Are you legally eligible for employment in this country?
Do you know anyone that currently works at Goodwill?
If yes, who?
Are any of your relatives employeed by Goodwill? *
If yes, who and where do they work?

Education

Elementary School – Name and Location
Years Completed
High School – Name and Location
Years Completed
Diploma or Degree
Undergraduate School – Name and Location
Course of Study
Diploma or Degree
Graduate School – Name and Location
Course of Study
Diploma or Degree
Other, please specify

Special Skills and Qualifications

Summarize any special training and certifications that may assist you in performing the position for which you are applying.

Skills
Have you ever had any job-related training in the United States Military
If yes, please describe.

References

List names, telephone numbers, title, relationship and how long you have known three business or work references who are not related to you, and are not a previous supervisor. If not applicable, list school or personal references who are not related to you.

Reference 1
Reference 2
Reference 3
 

Employment Experience

Start with your most recent job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, natural origin, disibility or other protected status.

Employer – Job Title – Dates Employed – Work Performed – Address – Phone
Starting and Ending Hourly Rate/Salary
Reason for leaving?
Supervisor – Supervisor Phone/Email
May we contact?
 
Employer – Job Title – Dates Employed – Work Performed – Address – Phone
Starting and Ending Hourly Rate/Salary
Reason for leaving?
Supervisor – Supervisor Phone/Email
May we contact?
 
Employer – Job Title – Dates Employed – Work Performed – Address – Phone
Starting and Ending Hourly Rate/Salary
Reason for leaving?
Supervisor – Supervisor Phone/Email
May we contact?
 
 

Applicant Statement and Release

 

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Goodwill Industries of East Texas, Inc. to verify their accuracy and to obtain reference information on my work performance. I hereby release Goodwill Industries of East Texas, Inc. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and as will and that either I or the Employer may terminate my employment at any time with or without notice or cause. Goodwill Industries of East Texas, Inc. is an equal opportunity employer. Goodwill Industries of East Texas, Inc. does not discriminate in employment on account of race, color, religion, nation origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

 
Agree Agree
 

Do not sign until you have read the above Applicant Statement and Release.

 
By typing my Full Name below, I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement and Release.
 

WE ARE AN EQUAL OPPORTUNITY EMPLOYER