Employment Application

If you would like the print and fill out the application form here is a PDF version of the application form.

This application must be filled out completely to be considered for employment. If you need help with the application, please call 541-345-1801. We gladly accept resumes, however, you must fill out this application to be considered.

Position Applied For:
First Name
Middle Name
Last Name
Address
City
State
Zip
Email
Telephone


Are you legally eligible to work in the US?
Yes No
Have you ever worked for Goodwill Industries?
Yes No
If Yes, Date:
Do you have relatives working for Goodwill Industries?
Yes No
If Yes, Name:
On what date would you be available for work?
Education City, State When attended List Diploma or Degree
College
Trade/Technical
Other

Please describe specialized training or skills you have that are relevant to this position:

Goodwill Industries is an equal opportunity employer. Goodwill will not discriminate or tolerate discrimination against any employee or applicant in any manner prohibited by law. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-related medical condition or disability.

Job History

Most Recent Employer - Are you presently working for this employer?
Yes No
If yes, may we contact?
Yes No
Company:
Type of Business:
Phone:
Address:
City:
State:
Zip:
Title:
Start Date:
End Date
Duties:
Reason for Leaving:


Company:
Type of Business:
Phone:
Address:
City:
State:
Zip:
Title:
Start Date:
End Date
Duties:
Reason for Leaving:

Job Related Background

Have you read the job description?
Yes No
Do you understand the basic requirements needed to perform this job?
Yes No
Are you physically able to perform this job safely and without a significant risk of substantial harm to yourself and others?
Yes No

NOTE: You may answer YES to the question above if you can perform all essential functions of the job with or without reasonable accommodation.

Have you ever been convicted of a felony or misdemeanor or agreed to a court settlement for a lesser crime after having been charged with a felony?

Yes No

(NOTE: a "YES" answer may not necessarily bar you from employment here) If YES, please explain and provide dates:

Availability for work

Retail employee work schedules will include day, evening and weekend hours based on the availability that you indicate on this application. We expect all of our employees to work multiple evening shifts each week, weekends and on certain holidays, as needed and determined by the Store Manager. Notify your manager immediately if your availability for work hours / days changes. Please indicate below the shifts you ARE able to work.

I am able to work the following: Mornings Afternoons Evenings
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Resume:

AGREEMENT & RELEASE

By signing this application I declare that the information provided by me is complete and true to the best of my knowledge. I understand that any misrepresentation or omission on this application may preclude an offer of employment or may result in a withdrawal of an employment offer or may result in my discharge from employment if I am already employed at the time of the misrepresentation or omission is discovered.

In the event I undergo a medical examination or evaluation as part of the job placement process, I agree to supply only information which is true to the best of my knowledge and I authorize the physician or his/her representative to provide any information or opinion, as it relates to my employment, to the Company. Regarding this examination or evaluation, I understand that if the Company determines that I have made any false oral or written statements or answers or any misrepresentation or any omission of significant information to the Company or to the physician or to his or her representative; the Company is entitled to terminate my conditional or actual employment at any time.

I authorize this company or its agents to verify any information on this application including, but not limited to references, criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement agencies to release any information concerning my background, and release any said persons, schools, companies or agencies from any liability for issuing this information.

I understand that the use of illegal drugs is prohibited during employment, and am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

I understand that employment at Goodwill is on an “at will” (that is, mutual consent) basis. Therefore, I agree that either I or the Company has the right to terminate with or without cause at any time, so long as there is no violation of applicable state or federal laws.


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