Goodwill Registration Application

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 NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Preferred Method of Contact?*
Are you a Goodwill employee?*
County you reside in:*
Gender*
Birthdate*

MonthDayYear
Date
Primary Language*
Marital Status*
Citizenship Status*
Race/Ethnicity*

Black or African AmericanCaucasian or WhiteMiddle Eastern/North AfricanNative AmericanAlaskan NativeAsianNative Hawaiian/Pacific IslanderHispanic/LatinX/LatinoOther
Highest level of education?*

High School DiplomaGED/HISETVocational Tech Certificate/Post SecondaryNo formal schoolingCompleted 8th gradeLess than high schoolTwo year college/AssociatesFour year college/Bachelor'sGraduate degree
Are you currently receiving an income or financial assistance?*

YesNo
How did you hear about Goodwill's programs & services?*

Bus AdYard SignLinkedInFacebookCommunity EventJob FairVeteran's OrganizationTransitional Housing/ShelterProbation & Parole OfficerCommunity PartnerEmail from GoodwillFlyerGoodwill Digital Training ClassText from DSSFamily/FriendZeta Driving SchoolGreat Jobs KCIMKOExpress EmploymentPaydayz Staffing SolutionNiagara WaterChallenge MfgParker McCroryInternational Paper
If you chose Community Partner, Event, Flyer, or do not see your answer above, please type in the business/organization name associated with selection.
Do any of the following apply to you?*

Justice InvolvedHealth Barriers/DisabilityLack of transportationLack of childcareLGBTQ+HomelessImmigrant or RefugeeDrug/Alcohol dependencyUnemployedUnderemployedMilitary/VeteranFamily member of Military/VeteranOtherNone
What Goodwill programs or services are you interested in? (Check all that apply)*

Bridge to TechnologyCertified Manufacturing Associate (CMfgA) Certification CourseDigital Skills TrainingGetting a job at GoodwillHelp finding a jobOther
How would you like Goodwill Mission to help?*
Should be Empty: