Goodwill Industries of Fort Worth, Inc.

List course of study or major, # of years completed, and if you earned a degree

List course of study or major, # of years completed, and if you earned a degree

List course of study or major, # of years completed, and if you earned a degree

List course of study or major, # of years completed, and if you earned a degree

List course of study or major, # of years completed, and if you earned a degree

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*PLEASE READ CAREFULLY BEFORE SIGNING* I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery. I understand that submission of an application does not guarantee employment. I further understand that, should an offer of employment be extended by Goodwill Industries of Fort Worth (hereinafter referred to as "GOODWILL INDUSTRIES") that such employment with GOODWILL INDUSTRIES is at will, for no specified duration and may be terminated by either GOODWILL INDUSTRIES or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of GOODWILL INDUSTRIES or its representatives used during the employment process is deemed a contract of employment real or implied. I understand that no representative of GOODWILL INDUSTRIES except the Chief Executive Officer has the authority to enter into any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and that any such agreements must be made in writing and signed by the Chief Executive Officer of GOODWILL INDUSTRIES. In consideration for employment with GOODWILL INDUSTRIES, if employed, I agree to conform to the rules, regulations, policies and procedures of GOODWILL INDUSTRIES at all times and understand that such obedience is a condition of employment. I understand that due to the nature of GOODWILL INDUSTRIES business, attendance and punctuality are considered essential requirements of every job at GOODWILL INDUSTRIES and that poor attendance or tardiness will result in disciplinary action. I understand that if offered a position with GOODWILL INDUSTRIES, I may be required to submit to a pre-employment medical examination, drug screening and background check as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employments tests and checks will result in withdrawal of any employment offer or termination of employment if already employed. I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to GOODWILL INDUSTRIES and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information. I understand that this application is considered current for three months. If I wish to be considered for employment after this period I must fill out and submit a new application. BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS. GOODWILL INDUSTRIES IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, AGE, DISABILITY, VETERAN STATUS OR ANY OTHER STATUS PROTECTED BY LAW.

I understand that, as a condition of my consideration for employment with GOODWILL INDUSTRIES, or as a condition of my continued employment with GOODWILL INDUSTRIES, GOODWILL INDUSTRIES may obtain a consumer report that includes, but is not limited to, my creditworthiness or similar characteristics, employment and education verifications, social security verification, criminal and civil history, personal interviews, DMV records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness. I hereby authorize and consent to GOODWILL INDUSTRIES procurement of such a report. I understand that, pursuant to the federal Fair Credit Reporting Act, GOODWILL INDUSTRIES will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making a decision regarding my fitness for employment with GOODWILL INDUSTRIES. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report.