Employment Application

* First Name:

Middle Name:

* Last Name:

Other names used that will be necessary to identify prior employment:

Current Address

* Address:
(Number and Street)

Apartment #:

* City:

* State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

* ZIP Code:

* County: Choose... Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether Miller Mitchell Monroe Montgomery Morgan Murray Muscogee Newton Oconee Oglethorpe Paulding Peach Pickens Pierce Pike Polk Pulaski Putnam Quitman Rabun Randolph Richmond Rockdale Schley Screven Seminole Spalding Stephens Stewart Sumter Talbot Taliaferro Tattnall Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth

* County: Choose... Autauga Baldwin Barbour Bibb Blount Bullock Butler Calhoun Chambers Cherokee Chilton Choctaw Clarke Clay Cleburne Coffee Colbert Conecuh Coosa Covington Crenshaw Cullman Dale Dallas DeKalb Elmore Escambia Etowah Fayette Franklin Geneva Greene Hale Henry Houston Jackson Jefferson Lamar Lauderdale Lawrence Lee Limestone Lowndes Macon Madison Marengo Marion Marshall Mobile Monroe Montgomery Morgan Perry Pickens Pike Randolph Russell Shelby St.Clair Sumter Talladega Tallapoosa Tuscaloosa Walker Washington Wilcox Winston

* County:

* How long have you lived there?

 

E-mail Address:

* Daytime Phone:(with Area Code)

Alternate Phone:(with Area Code)

* Social Security Number:(No Dashes)

* Re-enter your SSN#:(No Dashes)

Employment Application

* Are you 18 years of age or older? Yes No

* If hired, can you provide proof that you are legally authorized to work in the U.S.? Yes No

* Will you now or in the future require sponsorship for employment visa status? Yes No

* Do you have reliable transportation that can get you to work on time, every day? Yes No

* Have you previously applied for employment with KMMG? Yes No

* What prompted you to seek employment with KMMG? Please Select Advertisement Referral Other * Specify:

* Have you ever worked for KMMG or its affiliates, either directly or indirectly (e.g. temporary/contract)? Yes No

* Are you able to work day and night rotating shifts, weekends, holidays, and overtime? Yes No

Give the names and relationships of any of your relatives who are working for, or applying for work with, KMMG. (Information used for proper placement)

1. Name: Relation:
2. Name: Relation:
3. Name: Relation:
4. Name: Relation:
5. Name: Relation:

 

Employment Application

* At any past time, have you ever pled no contest, nolo or guilty to a felony or misdemeanor, or been convicted of a felony or misdemeanor, other than a "first offender discharge" under Georgia Code Annotated § 42-8-63?
Note: Do not include convictions that were sealed, eradicated or expunged, or convictions that resulted in a referral to a diversion program.
Yes No

* Are any charges currently pending against you?
Yes No

If you answered yes to either or both of the two preceding questions, please give dates and details.

NOTE: An applicant will not necessarily be denied employment solely on the grounds of answering "yes" to any of the previous questions. The date of the offense, nature of the offense, including any significant details that affect the description of the event, surrounding circumstances, and the relevance of the offense to the position(s) applied for, will be considered.

 

Operating a Company-owned Vehicle

* Do you have a current valid driver's license?
Yes No

* Has your license ever been suspended or revoked?
Yes No

* Do you have personal automobile insurance?
Yes No

* Have you ever been denied personal automobile insurance or has it ever been terminated or suspended?
Yes No

* Have you ever been convicted, pled guilty or pled nolo to a charge of DWI or DUI?
Yes No

* Are any charges currently pending against you?
Yes No

If you answered yes to either of the last two questions, please explain.

Your driving record will be reviewed through the appropriate state agency. If your job requires you to drive a vehicle, and you meet all other job-related requirements of the position, any job offer made to you will be contingent on the fact that your driving record conforms to applicable standards.

Consistent with KMMG's objective of promoting safety and safeguarding its company assets, team members who lease and/or operate any company-owned or provided vehicle (hereinafter "vehicle"), including but not limited to those who are required to operate a vehicle to perform their job functions, must meet, maintain, and follow all requirements, including driving eligibility requirements, in KMMG's Vehicle Services Policies and Procedures Manual or Kia Motors America relevant policy manual. KMMG will periodically review the driving record of any team member who operates a vehicle. If it is shown that a team member's driving record contains accidents and/or violations that exceed applicable standards, the team member will not be permitted to drive a company-owned vehicle.

You agree to pay any lease charge by payroll deduction. Any money owed KMMG or Kia Motors America, due to damage to a vehicle or unpaid lease payment, may be deducted from your pay check.

 

Education

High School / GED (General Educational Development)

* Did you graduate high school or successfully complete an accredited GED certification program?
Yes No

Did you obtain a diploma or a GED? Diploma GED

* High School NameGED Testing Facility

* City :

* State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

University, Community or Technical College

College Name:

City, State:

Major:

Degree: Please Select Associates Bachelors Masters Doctorate

Check the number of years completed:
None Less then 1 year    1 year    2 years    3 years    4 years   

Did you graduate or complete?
Yes No

Other University, Community or Technical College

College Name:

City, State:

Major:

Degree: Please Select Associates Bachelors Masters Doctorate

Check the number of years completed:
None Less then 1 year    1 year    2 years    3 years    4 years   

Did you graduate or complete?
Yes No

 

* Did you earn a degree in an industrial maintenance-related field?
Yes    No   

Experience

Other Certifications, Skills or Training if applicable to the position you are seeking:

 

Availability

* Eligible KMMG applicants will be required to successfully complete a pre-employment training program prior to receiving further employment consideration. Check all times that you are available for pre-employment training:

 

Employment History

* Are you currently employed?
Yes No

* How many years have you been employed full time?
None Less than 1 year 1 year or more 2 years or more 3 years or more

* Have you had any periods in which you were not employed for greater than 30 days?
Yes No

* Are you currently on a lay-off where you are eligible for recall?
Yes No

* Have you ever been terminated or asked to resign?
Yes No

* How many full days / partial days of scheduled work did you miss in the last 24 months, NOT INCLUDING vacations, holidays and other approved leave?
Full days: Partial days (including tardies or leave early):

Please list positions held and duties for each position. Start with your most recent position first. Do not reference a résumé. Please complete as much information as possible.

Please list all employment for the past five (5) jobs or ten (10) years, whichever is greater

Current/Most Recent Employer

Employer Name:

Reason For Leaving:

Phone Number:
(with area code)

City:

State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Starting Hourly Rate of Pay:

Final Hourly Rate of Pay:

Please list positions held and duties for each position. Start with your most recent position first.

Name and Title of Supervisor:

Have you ever received an unsatisfactory performance evaluation, or discipline for any reason?
Yes No

* Rate of pay is your base rate of pay excluding overtime premiums, special bonuses or allowances.

Previous Employer

Employer Name:

From:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

To:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Phone Number:
(with area code)

Reason For Leaving:

City:

State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Starting Hourly Rate of Pay:

Final Hourly Rate of Pay:

Please list positions held and duties for each position. Start with your most recent position first.

Name and Title of Supervisor:

Have you ever received an unsatisfactory performance evaluation, or discipline for any reason?
Yes No

* Rate of pay is your base rate of pay excluding overtime premiums, special bonuses or allowances.

Previous Employer

Employer Name:

From:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

To:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Phone Number:
(with area code)

Reason For Leaving:

City:

State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Starting Hourly Rate of Pay:

Final Hourly Rate of Pay:

Please list positions held and duties for each position. Start with your most recent position first.

Name and Title of Supervisor:

Have you ever received an unsatisfactory performance evaluation, or discipline for any reason?
Yes No

* Rate of pay is your base rate of pay excluding overtime premiums, special bonuses or allowances.

Previous Employer

Employer Name:

From:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

To:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Phone Number:
(with area code)

Reason For Leaving:

City:

State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Starting Hourly Rate of Pay:

Final Hourly Rate of Pay:

Please list positions held and duties for each position. Start with your most recent position first.

Name and Title of Supervisor:

Have you ever received an unsatisfactory performance evaluation, or discipline for any reason?
Yes No

* Rate of pay is your base rate of pay excluding overtime premiums, special bonuses or allowances.

Previous Employer

Employer Name:

From:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

To:
January February March April May June July August September October November December 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

Phone Number:
(with area code)

Reason For Leaving:

City:

State: Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Starting Hourly Rate of Pay:

Final Hourly Rate of Pay:

Please list positions held and duties for each position. Start with your most recent position first.

Name and Title of Supervisor:

Have you ever received an unsatisfactory performance evaluation, or discipline for any reason?
Yes No

* Rate of pay is your base rate of pay excluding overtime premiums, special bonuses or allowances.

Review

Important!

Please take a moment to review, verify and correct the information below. This information is critical to the successful processing of your application. Please make any necessary changes and click on "Submit my application" to complete the online application process.

First Name:

Last Name:

Street Address:

City:

State:

Phone:

E-mail:

Social Security #:

ZIP Code: