Application For Employment - Goodwill Industries Of Kanawha Valley, Inc.
ADVERTISEMENT
1
2
3Goodwill Industries
of Kanawha Valley, Inc
.
Application for Employment
Please Print
Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable
accommodation to the application and/or interview process should notify a representative of the Human Resources
Department
Position(s) applied for ____________________________________________ Date of Application_________________
Name ____________________________________________________________ Social Security #_____-_____-_____
Last
First
Middle
Address______________________________________________________________________________________________
Street
City
State
Zip Code
Telephone# (____)____________Mobile/Beeper/Other# (____)___________ Email Address ___________________
Referral Source (
_______________________________________________________________
How Did you Hear About Us?)
If you are under 18 and it is required, can you furnish a work permit? . . . . . . . . . . . . . . ___ Yes ___ No
If no, please explain: _________________________________________________________________________________
Have you ever been employed here before? If yes, give dates and positions: . . . . . . . . . . ___ Yes ___ No
______________________________________________________________________________________________________
Are you legally eligible for employment in this country? . . . . . . . . . . . . . . . . . . . . . . . . . ___ Yes ___ No
Date available for work . . . . ___/___/____ What is your desired salary range? . . . . . . . . . $_______________
Type of employment desired:
___ Full-Time
___ Part-Time
___ Temporary
___ Seasonal
___ Educational Co-Op
Are you able to perform the essential functions of the job for which you are applying with or without
reasonable accommodation?
This question is not designed to elicit information about an applicant’s disability. Please do not provide information about the existence of a disability, particular
accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.
___ Yes ___ No ___ Need more information about the job’s “essential functions” to respond
Driver’s License number required if driving may be required in the job for which you are applying
___________________________________ State ______
Answering “Yes” to either of the following questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of
the violation, rehabilitation and position applied for will be taken into account.
Have you ever pleaded “guilty” or “no contest” to, or been convicted of a crime? . . . . . . . . ___ Yes ___ No
If yes, please provide date(s) and details: ______________________________________________________________
______________________________________________________________________________________________________
Skills and Qualifications
Summarize any special training and/or certificates that may assist you in performing the position for which you are applying:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Computer Skills (Check appropriate boxes. Include Software titles and years of experience)
___ Word Processing _____________________ Years: ______
___ Email
______________ Years:
_____
___ Spreadsheet
_____________________ Years: ______
___ Internet ______________ Years: _____
___ Presentation
_____________________ Years: ______
___ Other
______________ Years:
_____
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business