Application

Applicant Information


Full Name:

Street Address:

Apartment/Unit #:

City:

State:

ZIP:

Phone:

Email:

Social Security Number

Position Applied for:

Date Available:

Desired Salary:

Are you authorized to work in the United States for any employer?
 Yes No

Have you ever worked for this company?
 Yes No

If yes, when?



Education


High School:

City, State:

From:

To:

Did you graduate?
 Yes No

Diploma:


College:

City, State:

From:

To:

Did you graduate?
 Yes No

Degree:


Other:

City, State:

From:

To:

Did you graduate?
 Yes No

Degree:



References

Please list three professional references.


Full Name:

Relationship:

Company:

Phone:

Address:


Full Name:

Relationship:

Company:

Phone:

Address:


Full Name:

Relationship:

Company:

Phone:

Address:



Previous Employment


Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?
 Yes No


Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?
 Yes No


Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?
 Yes No



Military Service


Branch:

From:

To:

Rank at Discharge:

Type of Discharge:

If other thank honorable, explain:



Disclaimer

Please read carefully before submitting.

Goodwin Brothers Shades & Specialties is an equal opportunity employer. Goodwin Brothers Shades & Specialties does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service,

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Goodwin Brothers Shades & Specialties to hire me. If I am hired, I understand that either Goodwin Brothers Shades & Specialties or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Goodwin Brothers Shades and Specialties has the authority to make any assurance to the contrary.

I attest that I have given to Goodwin Brothers Shades & Specialties true and complete information on this application. No requested information has been concealed. I authorize Goodwin Brothers Shades & Specialties to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

I agree.