Job Application Step 1 of 6 16% Desired Role(Required) Intern – Accounting Staff Accountant – TAX Staff Accountant – Attestation (Audit) PERSONAL DATAName(Required) First Middle Last Address(Required) Street Address City GeorgiaAlabamaAlaskaAmerican 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 Phone(Required)Email(Required) EDUCATIONEducation Details: Select All That Apply(Required) Undergraduate Graduate Other Undergraduate Degree DetailsSchoolCity, StateDegree/MajorYear of GraduationGPA: MajorGPA: OverallSpecialized Training/Extra-Curricular Activities Add RemoveGraduate Degree DetailsSchoolCity, StateDegree/MajorYear of GraduationGPA: MajorGPA: OverallSpecialized Training/Extra-Curricular Activities Add RemoveOther Education DetailsSchoolCity, StateDegree/MajorYear of GraduationGPA: MajorGPA: OverallSpecialized Training/Extra-Curricular Activities Add RemovePlease list any professional/technical designations you have obtained (e.g. CPA, JD): Please list other activities/interests (i.e. professional, community activities): EMPLOYMENT HISTORYPlease list the names of your current or previous employers in chronological order. Be sure to account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and provide business references. Use the comment box at the end of the form for additional details if necessary.Current or Last Employer InformationCurrent or Last Employer Name(Required) Phone #(Required) Complete Employer Address(Required) 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 Position Title(Required) Reporting To (Name & Position)(Required) Reason for Leaving(Required) May we contact this employer?(Required) Yes No Please explain. Current/Last Employment Dates & SalaryEmployment Start Date Month Day Year Employment End Date Month Day Year Starting Salary (annual) Final Salary (annual) Other (Bonuses/OT) Do you have an employment or non-compete agreement with your current employer? Yes No Please explain the agreement. Continue Adding Employers? Yes No Previous Employer #1 InformationPrevious Employer Name Phone # Complete Employer 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 Position Title Reporting To (Name & Position) Reason for Leaving May we contact this employer? Yes No If no, please explain. Previous Employer Dates & SalaryEmployment Start Date Month Day Year Employment End Date Month Day Year Starting Salary (annual) Final Salary (annual) Other (Bonuses/OT) Continue Adding Employers? Yes No Previous Employer #2 InformationPrevious Employer Name Phone # Complete Employer 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 Position Title Reporting To (Name & Position) Reason for Leaving May we contact employer? Yes No Please explain. Previous Employer #2 Dates & SalaryEmployment Start Date Month Day Year Employment End Date Month Day Year Starting Salary (annual) Final Salary (annual) Other (Bonuses/OT) OTHER INFORMATIONPlease indicate any actual experience, special training and qualifications that you have which you feel are relevant to the position for which you are applying.On what date would you be available to work?(Required) Month Day Year Are you currently authorized to work in the U.S.?(Required) Yes No Are you available to work:(Required) Full Time Part Time Are any of your educational or employment records under another name(s)? If so, please list below. Have you ever pleaded guilty or “no contest” to, or been convicted of a misdemeanor or felony, or have you been arrested for any matters for which you are out on bail or on your own recognizance pending trial (excluding minor traffic citations or arrests)?(Required) Yes No Please explain: REFERENCESProvide names and telephone number of persons with whom you have worked.Reference 1(Required)NameRelationshipPhone Add RemoveReference 2NameRelationshipPhone Add RemoveReference 3NameRelationshipPhone Add RemoveAdd other details on employment or references here. ACKNOWLEDGEMENTS:True and Correct Information Acknowledgement(Required)I certify that the information contained in this data sheet or any other documents filled out in connection with my employment, and in any interview is true and correct. I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that falsification of this data sheet in any detail is grounds for disqualification from further consideration or dismissal from employment in accordance with company policy. If employed, I understand this data sheet becomes part of my permanent employment record. I understand that employment with the Company is terminable at-will and is for no definite period and no implied, oral or written documents of the Company create a contract for specific term of employment. Acknowledge Reference & Background Check Acknowledgement(Required)I acknowledge that consideration for employment is contingent on the results of a reference and background check. Therefore, I hereby authorize this Company to (1) investigate the truthfulness of all statements made on this application; (2) contact my former employers and other listed references or any other persons who can verify information; (3) discuss the results of any investigation with other employees of this Company involved in the hiring process; and (4) check my criminal record. In addition, I give my consent for all contacted persons including former employers and personal references to provide the information concerning this application, and I release each such person from liability for providing information to this Company. Acknowledge Dispute Resolution Acknowledgement(Required)I also acknowledge that the Company promotes a voluntary system of alternative dispute resolution, which involves binding arbitration to resolve all disputes which may arise out of the employment context. Because of the mutual benefits which private binding arbitration can provide both the Company and myself, I voluntarily agree that any dispute arising from my seeking employment with the Company shall be submitted to and determined exclusively by binding arbitration under the Federal Arbitration Act. I understand that by voluntarily agreeing to this binding arbitration provision, both I and the Company give up our rights to a trial by jury. Acknowledge Applicant Signature(Required)Application Date Month Day Year EmailThis field is for validation purposes and should be left unchanged.