Rummel, Klepper & Kahl, LLP
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Jobs and Internships

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

Our firm does not discriminate in its hiring practices. All persons without regard to race, religion, color, national origin, sex, age, physical handicap, or veteran's status will be given equal consideration.

Information collected through this form will be kept confidental and will only be used for hiring purposes.
TELL US ABOUT YOURSELF
Name:
(First Name)

(MI)

(Last Name)
Address:
(Street)

(City)

(State)

(Zip)
Phone:
(Home)

(Mobile/Pager)
Drivers License #: State Issued:

Position applying for: RK&K Location:
Date of application: Salary requirement:
Your Social Security Number: - - (Optional)
If you were referred by one of our employees, indicate his/her name:
Are you under 18 years of age? No Yes
(If yes, you will be required to obtain and provide a valid state work permit)
Are you a U.S. Citizen? No Yes
Have you ever been convicted or pleaded guilty to a crime (excluding traffic citations)?
No Yes
If Yes, please explain:

  

TELL US ABOUT YOUR EDUCATION
School Graduation Date Degree Received Major/Minor
High School:
College or University:
Other Training:
Have you passed the EIT Exam? No Yes
Do you have your P.E. Registration? No Yes
P.E. Registration States:

  

TELL US ABOUT YOUR FORMER EMPLOYMENT
Current or most recent position:
Dates employed: From: To: Salary:
Company: Location:
Supervisor's Name: Supervisor's Phone number:
Reason for leaving:
Description of your duties:

Next most recent position:
Dates employed: From: To: Salary:
Company: Location:
Supervisor's Name: Supervisor's Phone number:
Reason for leaving:
Description of your duties:

Next most recent position:
Dates employed: From: To: Salary:
Company: Location:
Supervisor's Name: Supervisor's Phone number:
Reason for leaving:
Description of your duties:

  

TELL US ABOUT YOUR MILITARY EXPERIENCE
Branch of U.S. Service: Active duty dates: -
Major duties:
Service schools attended:

  

TELL US ANY SUPPLEMENTAL INFORMATION
List any other information that may be helpful in considering your application:

  

YOUR SIGNATURE

I understand that completing this application does not constitute an offer of employment and that my application may be rejected for any reason. I understand that employment with RK&K, regardless of length of service is considered at will @ and that RK&K may terminate the employment relationship at any time with or without cause. I also understand that providing false or misleading information on this form or in an interview is grounds for denial or immediate termination of employment.

I authorize RK&K to make a complete investigation of me, including, but not limited to my past employment history, scholastic records, motor vehicle driving records, and workers' compensation history. I authorize all persons and organizations to release any information concerning my background and hereby release all persons and organizations from liability for any damage whatsoever for issuing this information. I acknowledge that a telephonic facsimile (FAX) or photographic copy shall be as valid as the original.

I certify that the answers given by me to all of the questions on this application are, to the best of my knowledge and belief, true and correct without reservations. I further affirm that I have not knowingly withheld any facts or circumstances that would materially affect this application.

Under Maryland Law, an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.00.


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