Application for Employment​

Equal Employment Opportunity Statement

Goodwest Industries LLC is an equal opportunity employer.  We are committed to a policy of equal employment opportunity.  We will recruit, select, hire, train, promote, and compensate associates on the basis of personal competence and potential for advancement without regard to race, color, religion, sex, national origin, age over 40, marital status, disability or citizenship as well as other classifications protected by applicable state or local laws.  Our equal employment opportunity philosophy applies to all aspects of employment with GoodWest LLC including recruiting, hiring, training, transfer, promotion, job benefits, pay, dismissal, and social and recreational activities.​

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Position Applying For:​*

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Thank You!

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Desired Salary:​*

Required

Desired Shift:​

1st 7am – 3:30pm
2nd 3pm – 11:30pm
3rd 11pm – 7:30am
Willing to work other shift if desired shift is unavailable?

​

​

3am-3:30pm; 3 days a week plus every other Saturday
3pm-3:30am; 3 days a week plus every other Saturday

​

Date Available to Begin Work:​

​

Last Name:*

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First Name:*

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Middle Name:

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Address:*

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City:*

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State:*

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Postal Code:*

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Primary Phone:*​

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Secondary Phone:​

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Email:*​

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Referral Source:​

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Social Security Number:*​

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Date of Birth:*​

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Are you a U.S. Citizen?​

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No

Are you legally authorized to work in the U.S.?​

Yes
No

Are you 18 years of age or older?​

Yes
No

Have you ever been convicted of a felony or misdemeanor?​

Yes
No

If yes, please explain:

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If selected for employment are you willing to submit to a pre-employment drug screen?​

Yes
No

​

If selected for employment, by checking yes on the box you are agreeing to submitting to a background check?​

Yes
No

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School Name:​

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Location:​

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Years Attended:​

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Degree Received:

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Major:

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Education

Other training, certification, licenses held, skills or qualifications:​

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work experience

Employer:

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Dates Employed:

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Phone:

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Pay Rate:

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Supervisor:

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Address:

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State:

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Position:

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May we contact them?​

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Employer:

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Dates Employed:

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Phone:

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Pay Rate:

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Supervisor:

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Address:

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City:

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State:

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Postal Code:

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Position:

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Reason for Leaving:

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May we contact them?​

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Duties Performed:

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Employer:

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Dates Employed:

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Phone:

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Pay Rate:

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Supervisor:

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Address:

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Duties Performed:

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City:

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State:

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Postal Code:

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Position:

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Reason for Leaving:

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May we contact them?​

Yes
No

​

REFERENCES​

Name:*

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Title:*

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Company:*

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Phone:*

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Name:*​

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Title:*​

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Company:*​

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Phone:*

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Name:*​

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Title:*​

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Company:*​

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Phone:*​

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Reason for Leaving:

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ACKNOWLEDGEMENT AND AUTHORIZATION​*​

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By checking this box, I certify that all that all of the statements on this application form made by me are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that any misrepresentation of information shall be sufficient cause for rejecting my application, withdrawing of any offer of employment, or terminating my employment.​

Type Applicant Name:*​

Date:*

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​

This field is required.

Submit

Position Applying For:​*

Required

Thank You!

The form has been successfully sent.

Desired Salary:​*

Required

Desired Shift:​

1st 7am – 3:30pm
2nd 3pm – 11:30pm
3rd 11pm – 7:30am
Willing to work other shift if desired shift is unavailable?

​

​

3am-3:30pm; 3 days a week plus every other Saturday
3pm-3:30am; 3 days a week plus every other Saturday

​

Date Available to Begin Work:​

​

Last Name:*

Required

First Name:*

Required

Middle Name:

​

Address:*

Required

City:*

Required

State:*

Required

Postal Code:*

Required

Primary Phone:*​

This field is required.

Secondary Phone:​

​

Email:*​

Required

Referral Source:​

​

Social Security Number:*​

Required

Date of Birth:*​

Required

Are you a U.S. Citizen?​

Yes
No

Are you legally authorized to work in the U.S.?​

Yes
No

Are you 18 years of age or older?​

Yes
No

Have you ever been convicted of a felony or misdemeanor?​

Yes
No

If yes, please explain:

This field is required.

If selected for employment are you willing to submit to a pre-employment drug screen?​

Yes
No

​

If selected for employment, by checking yes on the box you are agreeing to submitting to a background check?​

Yes
No

​

School Name:​

This field is required.

Location:​

This field is required.

Years Attended:​

This field is required.

Degree Received:

This field is required.

Major:

This field is required.

Education

Other training, certification, licenses held, skills or qualifications:​

This field is required.

work experience

Employer:

This field is required.

Dates Employeed:

This field is required.

Phone:

This field is required.

Pay Rate:

This field is required.

Supervisor:

This field is required.

Address:

Required

City:

Required

State:

Required

Postal Code:

Required

Position:

This field is required.

May we contact them?​

Yes
No

​

Employer:

This field is required.

Dates Employeed:

This field is required.

Phone:

This field is required.

Pay Rate:

This field is required.

Supervisor:

This field is required.

Address:

Required

City:

Required

State:

Required

Postal Code:

Required

Position:

This field is required.

Reason for Leaving:

This field is required.

May we contact them?​

Yes
No

​

Duties Performed:

Required

Employer:

This field is required.

Dates Employeed:

This field is required.

Phone:

This field is required.

Pay Rate:

This field is required.

Supervisor:

This field is required.

Address:

Required

Duties Performed:

Required

City:

Required

State:

Required

Postal Code:

Required

Position:

This field is required.

Reason for Leaving:

This field is required.

May we contact them?​

Yes
No

​

REFERENCES​

Name:*

Required.

Title:*

Required.

Company:*

Required.

Phone:*

Required.

Name:*​

Required.

Title:*​

Required.

Company:*​

Required.

Phone:*

Required.

Name:*​

Required.

Title:*​

Required.

Company:*​

Required.

Phone:*​

Required.

Required.

Reason for Leaving:

This field is required.

ACKNOWLEDGEMENT AND AUTHORIZATION​*​

​

By checking this box, I certify that all that all of the statements on this application form made by me are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that any misrepresentation of information shall be sufficient cause for rejecting my application, withdrawing of any offer of employment, or terminating my employment.​

Type Applicant Name:*​

Date:*

​

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​

This field is required.

​

This field is required.

​

This field is required.

​

This field is required.

​

This field is required.

​

This field is required.

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This field is required.

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This field is required.

​

This field is required.

Duties Performed:

Required

SUBMIT

Position Applying For:​*​

This field is required.

Thank You!

The form has been successfully sent.

Desired Salary:​*​

This field is required.

Desired Shift:​​

1st 7am – 3:30pm
3am-3:30pm; 3 days/week plus every other Sat
2nd 3pm – 11:30pm
3pm-3:30am; 3 days/week plus every other Sat
3rd 11pm – 7:30am
Other shift if desired is unavailable?

This field is required.

Date Available to Begin Work:​​

This field is required.

Last Name:*​

This field is required.

First Name:*​

This field is required.

Middle Name:​

This field is required.

Address:*​

This field is required.

City:*​

This field is required.

State:*​

 required.

Postal Code:*​

 required.

Primary Phone:*​

This field is required.

Secondary Phone:​

This field is required.

Email:*​

This field is required.

Referral Source:​

This field is required.

Social Security Number:*​

This field is required.

Date of Birth:*​

This field is required.

Are you a U.S. Citizen?​

Yes
No

This field is required.

Are you legally authorized to work in the U.S.?​

Yes
No

This field is required.

Are you 18 years of age or older?​

Yes
No

This field is required.

Have you ever been convicted of a felony or misdemeanor?​

Yes
No

This field is required.

If yes, please explain:​

This field is required.

If selected for employment are you willing to submit to a pre-employment drug screen?​

​

Yes
No

This field is required.

If selected for employment, by checking yes on the box you are agreeing to submitting to a background check?​

Yes
No

This field is required.

EDUCATION​

School Name:​​

This field is required.

Location:​​

This field is required.

Years Attended:​​

This field is required.

Degree Received:​

This field is required.

Major:​​

This field is required.

School Name:​​

This field is required.

Location:​​

This field is required.

Years Attended:​​

This field is required.

Degree Received:​

This field is required.

Major:​​

This field is required.

School Name:​​

This field is required.

Location:​​

This field is required.

Years Attended:​​

This field is required.

Degree Received:​

This field is required.

Major:​​

This field is required.

Other training, certification, licenses held, skills or qualifications:​​

This field is required.

WORK EXPERIENCE​

Employer:​

This field is required.

Dates Employed:​

This field is required.

Phone:​

This field is required.

Pay Rate:​

This field is required.

Supervisor:​

This field is required.

Address:​

This field is required.

City:​

This field is required.

State:​

 required.

Postal Code:​

 required.

Position:

This field is required.

Duties Performed:​

This field is required.

Reason for Leaving:​

This field is required.

May we contact them?​​

Yes
No

This field is required.

Employer:​

This field is required.

Dates Employed:​

This field is required.

Phone:​

This field is required.

Pay Rate:​

This field is required.

Supervisor:​

This field is required.

Address:​

This field is required.

City:​

This field is required.

Reason for Leaving:​

This field is required.

State:​

 required.

Postal Code:​

 required.

Position:

This field is required.

Duties Performed:​

This field is required.

May we contact them?​​

Yes
No

This field is required.

Employer:​

This field is required.

Dates Employed:​

This field is required.

Phone:​

This field is required.

Pay Rate:​

This field is required.

Supervisor:​

This field is required.

Address:​

This field is required.

City:​

This field is required.

State:​

 required.

Postal Code:​

 required.

Position:

This field is required.

Duties Performed:​

This field is required.

Reason for Leaving:​

This field is required.

May we contact them?​​

Yes
No

This field is required.

REFERENCES​

Name:*​

This field is required.

Title:*​

This field is required.

Company:*​

This field is required.

Phone:*​

This field is required.

Name:*​

This field is required.

Title:*​

This field is required.

Company:*​

This field is required.

Phone:*​

This field is required.

Name:*​

This field is required.

Title:*​

This field is required.

Company:*​

This field is required.

Phone:*​

This field is required.

This field is required.

By checking this box, I certify that all that all of the statements on this application form made by me are true, complete and correct to the best of my knowledge and belief, and are made in good faith. I understand that any misrepresentation of information shall be sufficient cause for rejecting my application, withdrawing of any offer of employment, or terminating my employment.​​

This field is required.

ACKNOWLEDGEMENT AND AUTHORIZATION​*​

Type Applicant Name:*​

This field is required.

Date:*​

This field is required.

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