Get free help from a Career Specialist! Name(Required) First Last Email(Required) Phone(Required)Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you able to provide proof of eligibility to work in the U.S.?(Required) Yes No Are you currently homeless?(Required) Yes No Do you have a brain injury?(Required) Yes No Are you a veteran?(Required) Yes No If so, dates of service:(Required)Discharge status:(Required)Are you a family member or household member of a veteran?(Required) Yes No Which employment and training services would you like to receive? (Check all boxes that apply)(Required) Job search help Job readiness/Skills training Employment training for individuals 55+ Veteran family employment help Homeless veteran employment services Other service(s) needed:Terms of Employment ServicesIf accepted for services, it is recognized that all individuals have the right to terminate his or her relationship with GINM for any reason and at any time. GINM reserves the same right. GINM adheres to the tenets of the ADA. Applications for service will be reviewed and if appropriate, you will be contacted for an initial intake. Terms of Program ParticipationGoodwill Industries of New Mexico (GINM) has the right to refuse service to program participants. GINM is a drug free workplace. GINM does not tolerate any conduct that is harassing, disruptive or forceful, including sexual harassment. GINM employs, pays, promotes, assists and trains a wide variety of people. Thus, your religious affiliation, the nature of your disability, your race or ethnicity, your age, your political affiliations, your sexual orientation, your gender, or your marital status do not matter to GINM. In addition, participants will not be subject to reprisal or retaliation for reporting, in good faith, actions that they feel violate the law. Our company is an Equal Opportunity Employer and as such affirms the right of every person to participate in all aspects of employment without regard to gender, race, color, religion, national origin, ancestry, age, marital status, sexual orientation, pregnancy, disability, citizenship, military or veteran status, gender expression and/or identity, or any other status or characteristic protected by federal, state, or local law. For full details of conditions of receiving GINM services, please contact Goodwill or consult your program handbook. READ CAREFULLY BEFORE SIGNING: I certify that the information given by me on this application for services is true and correct to the best of my knowledge and belief. I understand that any misleading or false statement, and any omission made by me, may render this application void; and if I am accepted, any inaccurate, false or misleading information on any employment documents could result in separation of services. I consent to all physical and other examination(s) required as a condition of continued relationship with GINM. I authorize GINM to verify any information provided by me and hereby release GINM from any liability associated with verification of information. I further understand that GINM is committed to providing a drug free environment.