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Personal Information

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What prompted you to seek employment with KMMG?

Additional Information

Please be accurate in filling out this application. KMMG verifies work history, compensation and educational information.

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Employment History

Education History

I agree to submit to a post-offer, pre-employment physical examination and drug screen, and to periodic drug (including alcohol) screenings as permitted by law.  I agree to execute any release or waiver, including, if necessary, a waiver of rights conferred by the American Health Insurance Portability and Accountability Act of 1996 (HIPAA), that is required to authorize a health care provider or medical review officer to release to the Company the results of any such physical exam/drug screen.  I also authorize KMMG to request from my present and former employers, and any other source, any information which KMMG may lawfully seek in considering my application for employment, and I hereby release KMMG, and such other employers or sources, from any liability whatsoever for requesting and/or providing such information. I also authorize the Company to provide truthful information concerning any employment with Company to future employers and I agree to hold it harmless for providing such information. 

I understand that this employment application and any other Company documents are not promises of employment.  Should I be employed, I agree to conform to the rules and policies of KMMG.  I understand that my employment will be as an at-will employee at all times.  I also understand that my first six (6) months of employment will specifically be on a trial basis, running from the date of my hire.  I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice and that the Company has a similar right.  I understand that no manager, representative, or agent of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except that the President may do so in writing.

I certify that I have received a separate written notification that the Company may obtain a “consumer report” (for example, criminal history, driving records, etc.) on me for use in connection with my application and, if I am hired, my employment. I authorize the Company to obtain this report.
This application will be considered “active” for a maximum of 12 months.  If I wish to be considered for employment after that time, I must reapply.
I have read and understand the information above.

I UNDERSTAND THAT I WILL BE SUBJECT TO DISMISSAL IF ANYTHING IN THIS APPLICATION IS FOUND TO BE FALSE OR MISREPRESENTED.

Candidate Sign Off

I certify that all of the information in this application is true and correct as of this date.