Goodwill Cares Community Assistance Program Application Details

Are you in need of new clothes but don't have the money to buy them? If so, you may be interested in a Goodwill clothing voucher. A Goodwill clothing voucher is a coupon that allows you to purchase clothing and other items from Goodwill at a discounted price. In this blog post, we will provide more information about Goodwill clothing vouchers and how to use them. We will also discuss the benefits of using a Goodwill clothing voucher. So, if you are looking for a way to save money on clothes, keep reading.

The listing includes information about the goodwill clothing voucher. It's worth taking a few minutes to learn this before you begin filling in your document.

Form NameGoodwill Clothing Voucher
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namesclothing vouchers for adults, goodwill clothing voucher, goodwill voucher form, goodwill vouchers

Form Preview Example

Community Assistance Program

For questions contact Bill Jansen at:

Referral Agent to complete and fax this application to:

(414) 448-1182

Page 1 of 2

revised 7-21-16

(Please print clearly)

Name of Candidate: _________________________________________ Date of Birth: ________________

Candidate Address: ________________________________________________

City, State and Zip: ________________________________________________

Primary Phone: (_________) ________________________________________

Members of candidate’s household:

Name: ______________________________ Relationship: _____________

Date of Birth: ______________

Name: ______________________________ Relationship: _____________

Date of Birth: ______________

Name: ______________________________ Relationship: _____________

Date of Birth: ______________

Name: ______________________________ Relationship: _____________

Date of Birth: ______________


Candidate must be 18 years or older. Goodwill requests a copy of your agency’s 501(c)(3) tax exempt form for our files. If your agency is taxable, we request a copy of your informational pamphlet. We reserve the right to refuse applications from any agency that does not provide us with appropriate verification. Also see the guidelines on the bottom of page 2.

Choose the preferred Goodwill store for shopping (from below):___________________

Wisconsin: Bay View • Beaver Dam Brookfield • Brown Deer Delavan Fond du Lac Franklin • Grafton • Janesville Kenosha Menomonee Falls Milwaukee-East#1on Palmer Street Milwaukee-East#2 on Oakland Avenue Milwaukee-North on 91st Street Mount Pleasant/Racine New Berlin Oak Creek Oconomowoc Pewaukee Sheboygan Waukesha Wauwatosa West Allis West Bend

Illinois: Addison Arlington Heights-North on Dryden Ave Arlington Heights-South on Algonquin Rd Aurora Bartlett Batavia

Bloomingdale Bolingbrook Carol Stream Carpentersville Chicago (West Loop) Des Plaines Downers Grove Elmhurst Frankfort Glendale Heights • Hoffman Estates • Joliet • Lake Zurich • Lemont • Lombard • Montgomery Mundelein Naperville New Lenox Northbrook North Riverside Orland Park • Palatine on Rand Road Plainfield • Romeoville • Round Lake Beach Saint Charles South Elgin Skokie coming in October 2016 • Westchester • Willowbrook Woodridge Yorkville

Page 2 of 2

Please write a summary of why this candidate needs assistance from Goodwill:






Items needed: Clothing______



Referral (please print clearly)

Referral Contact Name: __________________________________________________________________

Referral Agency: ________________________________________________________________________

Street Address: ________________________________________________________________________

City, State and Zip: _____________________________________________________________________

Work Phone: (________) ______________________Cell Phone (optional): (________) _______________

*Referral Contact

E-Mail address: _______________________________________________________________________

*please note: Referral Contact will be notified by e-mail the dollar value of the voucher within ten days from the date this application is received. If you have not heard from Goodwill after a two week time frame, please contact Bill Jansen by email.

Applications are processed based on availability of funding

Guidelines (revised 7-21-16):

Only two (2) applications per agency per month will be considered, due to budget limitations.

This electronic voucher program is intended to assist candidates with an immediate need. If the need persists, the approved candidate may become eligible again to receive a voucher six months later.

Goodwill does not provide assistance with major appliances, baby cribs, car seats, nor any monetary assistance such as rent, mortgage, utilities, or food. Mattresses and box springs are seldom available.

Approved candidates will need to arrange for pick-up of all items selected at the Goodwill store.

Applications are processed in the order that they are received via fax beginning the 1st of each month.

Employees from any referring agency are not eligible to participate in this assistance program.

Before shopping can begin at the Goodwill store, each approved candidate will need to show to a store supervisor a state-issued ID with name and birth date to match against the electronic voucher.

Vouchers are held electronically in the stores for 60 days, after which time they expire.

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