Goodwill Registration Application
Thank you for your interest in Goodwill supporting you to discover your potential and adapt for the future through the power of work. All Goodwill programs and services are available at no cost. Please enter your contact information below and our team will be in contact with you soon to get started.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Preferred Method of Contact?
*
Please Select
Phone
Text Message
Email
Are you a Goodwill employee?
*
Please Select
Yes
No
How did you hear about Goodwill's programs & services?
Bus Ad
Yard Sign
LinkedIn
Facebook
Community Event
Job Fair
Veteran's Organization
Transitional Housing/Shelter
Probation & Parole Officer
Zeta Driving School
Community Partner
Email from Goodwill
Flyer
Goodwill Digital Training Class
Text from DSS
Family/Friend
If you chose Community Partner, Event, Flyer, or do not see your answer above, please type in the business/organization name associated with selection.
What Goodwill programs or services are you interested in? (Check all that apply)
*
Bridge to Technology
Certified Manufacturing Associate (CMfgA) Certification Course
Digital Skills Training
Getting a job at Goodwill
Help finding a job
Reentry Services
Other
County you reside in:
*
Gender
*
Please Select
Male
Female
Other
Birthdate
*
-
Month
-
Day
Year
Date
Primary Language
*
Please Select
English
Spanish
Other
Marital Status
*
Please Select
Divorced
Married/Partnered
Single
Widow/Widower
Citizenship Status
*
Please Select
US Citizen
Non US Citizen allowed to work
Race/Ethnicity
*
Black or African American
Caucasian or White
Two or more races
Middle Eastern/North Africa/Arab World
American Indian
Alaskan Native
Asian
Native Hawaiian
Pacific Islander
Hispanic/Latin X/Latino
Native American
Samoan
Other
Military History (Please check all that applies)
*
Currently serving or Veteran
Caregiver of Person with Military History
Has Documented Disabilities
Disabilities Service Connected
Family Member of Person with Military History
Military Service Documented
N/A
Highest level of education?
*
High School Diploma
GED/HISET
Vocational Tech Certificate/Post Secondary
No formal schooling
Completed 8th grade
Less than high school
Two year college/Associates
Four year college/Bachelor's
Graduate degree
Do you identify with the LGBTQ+ community?
*
Please Select
Yes
No
How would you like Goodwill Mission to help?
*
Submit
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