GoodBiz Participant Intake Form

GoodBiz Participant Agreement Form
All participants are required to have a legitimate business that is registered with the state of Texas.

In order to provide the best learning environment for participants, Goodwill has set the following expectations for participants enrolled in GoodBiz.
Attendance
All participants are expected to attend classes throughout the entirety of the program. However, when a Participant is absent from scheduled coaching mentoring or training sessions; the participant is expected to provide notice to the Global Good Fund coach/mentor as well as The Global Good Fund Coordinator and The Goodwill Coordinator, in advance by telephone or email. Participants that miss more than 4 sessions (2 during the leadership sessions and 2 during the mentor sessions)will be dropped from the program and not be eligible for graduation with the incentives. All participants are expected to arrive for each session on time. Participant tardiness can be disruptive to the process of the program. Participants that continuously arrive tardy (2 during the leadership sessions and 2 during the mentor sessions)will be dropped from the program and not be eligible for graduation with the incentives.
Behavior
All participants are expected to communicate professionally and abide by standards of personal communication in all aspects of the GoodBiz program. These standards include:
1. Courtesy
2. Appropriate Language
3. Consideration
4. Focus
5. Responsibility
6. Attentiveness
Assigned Homework / Activities
Assignments given to participants by The Global Good Fund coaches and mentors, as well as GoodwillCoordinator, must be completed in a timely manner. The 360 Mirror will be assigned during the month of January 2024. You must complete the assessment along with 25 of your colleaguespeers or family members around you and your business before the deadline set by the GoodBiz Coordinators.
GoodBiz Timeline
By signing this form, you are agreeing to all of the above Participant expectations.
Name:*

First NameLast Name
Date*

MonthDayYear
Date

Name:*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Last 4 of SSN:*
Driver's License # and State*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date*

MonthDayYear
Date
Have You Ever Been Convicted Of A Crime (ANY crime, misdemeanor and / or Felony)?*

YesNo
Please Explain (Offense, Current Status, Dates)
Today's Date:*

MonthDayYear
Date
Today's Date:*

MonthDayYear
(Authorization expires one year from this date)
Name*

First NameLast Name
Prior Name(s) Used

First NameLast Name
Social Security Number:*
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Current Address*

Street Address

County

CityState / Province

Postal / Zip Code
Years*
Months*
Previous Address

Street Address

County

CityState / Province

Postal / Zip Code
Years
Months
Drivers License/State ID#*
State:*
Expires:*
Email Address:*
example@example.com
Today's Date*

MonthDayYear
Date

CONSENT AND RELEASE FORM
I,*
being either of legal age to consent or the legal parent or guardian of , a minor child or person unable to consent on his or her own behalf, hereinafter the (“other featured individual”) hereby grant to Goodwill Industries of East Texas, Inc. The right and permission to use the following collectively referred to as “Tangible and Intangible Items” for any lawful, non-commercial purpose and in any and all media without payment or any other consideration
- pictures
- negatives
- reproductions and copies of original pictures
- negatives or recordings of me/the other featured individual
- any recordings that may be made of my/the other featured individual’s voice or likeness
- any written words or stories supplied by me/the other featured individual or written about me/the other featured individual
In addition, I waive any right to inspect or approve the finished product wherein my likeness appears.

I hereby acknowledge that Goodwill Industries of East Texas, Inc. may grant the same permissions as set forth in this Consent and Release Form to Goodwill Industries International, Inc. (“GII”) under the same terms and conditions.

This Consent and Release Form shall remain in effect for a period of five years unless revoked. I understand that I may revoke this consent by submitting a written request to the HR Department. I understand that, if I revoke this consent, my revocation will not have any effect on actions already taken by Goodwill Industries of East Texas, Inc. in reliance on my consent.

By signing below, I certify that I have read and understand this Consent and Release Form, I have been given the opportunity to have my questions answered, and I have been informed that Goodwill Industries of East Texas, Inc.must give me a copy of this document once it is signed.
Printed Name*
Date*

MonthDayYear
Date
Goodwill Industries of East Texas, Inc. By:
Printed Name & Title
Date

MonthDayYear
Date
Should be Empty:

GoodBiz Participant Intake Form

Participant Information

Participant Business Information

GoodBiz Participant Agreement Form

Attendance

Behavior

Assigned Homework / Activities

GoodBiz Timeline

CONSENT AND RELEASE FORM