job application

Goodwill Columbus is an equal opportunity employer. All hiring, promotions, compensation, benefits, performance reviews, etc. are done without regard to race, color, religion, sex, national origin, ancestry, citizenship, age, marital status, disability, medical condition, or sexual orientation, except when a bona fide occupational qualification exists.

Fields marked with an asterisk (*) are required

Your Full Legal Name:

*First Name:

Middle Name:

*Last Name:

Your Contact Information:

*Street address:	Apt. number:
*City	*State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY	*Zip code:
Email address:

*Home phone (no spaces or hyphens): Phone number (7-digit):	*Work phone (no spaces or hyphens): Phone number (7-digit):
Cell phone (no spaces or hyphens): Phone number (7-digit):

Employment Information:

Do you have a High School Diploma or a GED? No Yes		Are you 18 years or older? No Yes
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? No Yes		Do you have a valid Ohio Driver's License (if applicable to position)? No Yes

Position Information:

*Position applied for:		How many years of experience do you have in the position being applied for?
Professional/Technical Considerations and Credentials:

Previous Goodwill Employment:

Have you ever been employed at Goodwill? No Yes		If yes, please list dates employed:
How did you learn about Goodwill? Relative Advertisement Employment Agency Walk-in Word of Mouth Internet Search Engine Other Current Employee: Employee's Name:

Employment History (List most recent employer first):

Employer #1:

Name:	Phone # (no spaces or hyphens):	Hours/week worked:
Address:	Supervisor:	Rate/Salary:
Reason for leaving:	Start date:	Ending date:
Job Duties/Description:		May we contact this employer?NoYes

Employer #2:

Name:	Phone # (no spaces or hyphens):	Hours/week worked:
Address:	Supervisor:	Rate/Salary:
Reason for leaving:	Start date:	Ending date:
Job Duties/Description:		May we contact this employer?NoYes

Employer #3:

Name:	Phone # (no spaces or hyphens):	Hours/week worked:
Address:	Supervisor:	Rate/Salary:
Reason for leaving:	Start date:	Ending date:
Job Duties/Description:		May we contact this employer?NoYes

Personal References:

Name:	Years Known:	Address:	Phone #:
Name:	Years Known:	Address:	Phone #:
Name:	Years Known:	Address:	Phone #:

Goodwill Columbus
1331 Edgehill Road
Columbus, OH 43212-3163
Phone: 614.294.5181
TTY: 614.583.0293
Fax: 614.294.6895