Horizon Goodwill Online Employment Application  

Your application is confidential and goes directly to our Human Resources Department

     First Name / Middle Name / Last Name                                                                                                                          Date of Application   (99/99/9999)
                             
     Present Address (Street, City, State, Zip)                                                                             Daytime Telephone     Alternate Telephone
             
     Prior Address If present is less than 3 years (Street, City, State, Zip)                                                    Email Address
              

    Referral Source (Please select the appropriate category) Choose one                                                 Name the Referral Source

                                       
     Are you legally authorized to work in the United States?               
     Position Information
     Position you are applying for                                                                 Location
                   

     Date available to start?          
     Type of employment desired:     
     What is your desired salary range or hourly rate of pay?          Per     
     Will you work overtime if required?                    If No, please explain below:
 
     Will you travel if the job requires it?          
     Driver's License Number & State required if driving company vehicles:            
     Have you ever been bonded?          
     If you are under 18 and it is required, can you furnish a work permit?                    If No, please explain below:
 

     Have you ever been employed here before?               

          If YES, give dates:     From       (mm/yyyy)      To     
     Have you submitted an application here before?           

          If YES, give date(s) and position(s):               
     Have you ever plead "guilty" or "no contest" to, or been convicted of a felony?          

               If Yes, please provide date(s) and details:
 
     If necessary, best time to call you at home is      

     May we contact you at work?     
               If "Yes", work number and best time to call:      

     Employment History
Job 1
     Previous Employer (or None)                                                                                                        Employer Phone
               
     Address (Street, City, State, Zip)
     
     Starting / Final Job Title                                             Start Date    (mm/yyyy)    End Date
                       
     Salary                                                                                Other Compensation
          per                    
     Immediate Supervisor and Title                                                                   May we contact for reference?
                              
     Reason for Leaving
          
      Summarize the type of work performed and job responsibilities
          
      What did you like most about your position?
          
      What were the things you liked least about the position?
          
Job 2
     Previous Employer (or None)                                                                                                        Employer Phone
               
     Address (Street, City, State, Zip)
     
     Starting / Final Job Title                                             Start Date   (mm/yyyy)   End Date
                      
     Salary                                                                                Other Compensation
          per                    
     Immediate Supervisor and Title                                                                    May we contact for reference?
                              
     Reason for Leaving
          
     Summarize the type of work performed and job responsibilities
          
     What did you like most about your position?
          
     What were the things you liked least about the position?
          
Job 3
     Previous Employer                                                                                                                 Employer Phone
               
     Address (Street, City, State, Zip)
     
     Starting / Final Job Title                                             Start Date    (mm/yyyy)   End Date
                      
     Salary                                                                                Other Compensation
          per                    
     Immediate Supervisor and Title                                                                    May we contact for reference?
                              
     Reason for Leaving
          
      Summarize the type of work performed and job responsibilities
          
     What did you like most about your position?
          
     What were the things you liked least about the position?
          
     Have you ever been fired or asked to resign from a job?          
     If Yes, please explain:  
     Education Background
     School (or None)                                                                              Years Completed                        GPA
                                   
     Degree                                                                                         Major
                         
     School                                                                                        Years Completed                        GPA
                                   
     Degree                                                                                         Major
                         
     School                                                                                        Years Completed                        GPA
                                   
     Degree                                                                                         Major
                         
     School                                                                                        Years Completed                        GPA
                                   
     Degree                                                                                         Major
                         
     References
                               Name                                               Title                                   Relationship to You                         Telephone

            Number of
             Years Known 

     
     
     
     Related Information
     To what job related organizations (professional trade, etc) do you belong?
 
     List special accomplishments, publications, awards, etc.
 

     In your current or prior job, have you ever written instructions or directions to be followed by employees or customers?

                           If YES, please explain below:      (120 characters available)
 
     Skills and Qualifications
     Summarize any special training skills, licenses, and/or certifications that may assist you in the position for which you are applying.

        Include knowledge of computer software such as Microsoft Word or Excel.
 
     Applicant Statement

Screening tests for alcohol and illegal drug use may be required before hiring and during your employment here. We are proud to be a drugfree workplace.
I certify that all the information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume' or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, and federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be neccesary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no implied oral or written agreements contrary to the foregoing express langiage are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand taht any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i)eliminate me from any further consideration for employment, or (ii) may result in my immediate discharge from the employer's service whenever it is discovered.

Please check here to confirm that you have read and understand the applicant and drugfree workplace statements.

After you click Submit, you will be taken to the Affirmative Action page.  Once there, you can check a box to not disclose any information, or you can complete the form.

This is a mandatory step in the application process.  Once you submit the Affirmative Action form, you will receive a message that your application was received.