Dopkins Employment Application

Step 1 of 4

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Skills & Qualifications
Summarize any special training skills, languages, and/or certificates that may assist you in performing the position for which you are applying:
Educational Background
Starting with your most recent school attended, provide the following information (minimum 1):
School*
City*
State*
Number of Years Completed*
Degree or Certification Received or Anticipated (MBA, BA, AAS, GED, etc.):*
Major/Minor*
School
City
State
Number of Years Completed
Degree or Certification Received or Anticipated (MBA, BA, AAS, GED, etc.):
Major/Minor
School
City
State
Number of Years Completed
Degree or Certification Received or anticipated (MBA, BA, AAS, GED, etc.):
Major/Minor
School
City
State
Number of Years Completed
Degree or Certification Received or anticipated (MBA, BA, AAS, GED, etc.):
Major/Minor
References
List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.
Full Name*
Occupation*
Relationship to You*
Phone*
Email*
Number of Years Known*
Full Name*
Occupation*
Relationship to You*
Phone*
Email*
Number of Years Known*
Full Name*
Occupation*
Relationship to You*
Phone*
Email*
Number of Years Known*
AN EQUAL OPPORTUNITY EMPLOYER

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Related Information
When answering these questions, please exclude any information that would reveal sex (including pregnancy), race, color, religion, national origin, citizenship, age, disability, genetic information, or other similarly protected status.
To what job-related organizations (professional, trade, etc.) do you belong?
List special accomplishments, publications, awards, etc.
List any relevant volunteer work.
Is there any other job-related information you want us to know about you?
Applicant Statement
I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and education institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing expressed language are valid unless they are in writing and signed by the employer’s managing partner.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that the federal immigration laws require me to complete an I-9 Form in this regard.

I understand that reasonable safeguard will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with the employer’s affiliate(s) and third parties engaged by the employer to perform services for the employer. Any personal information shared with an affiliate or third party is to be used solely to perform the services requested by the employer.

Dopkins & Company, LLP does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purposes of limiting or excluding an applicant from consideration for employment on the basis of his or her sex (including pregnancy), race, color, religion, national origin, citizenship, age, disability, genetic information, or any other protected status under applicable federal, state, or local law.

Mandatory Employer Disclosure
Notice to Maryland applicants: UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONDINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.
Notice to Massachusetts applicants: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Notice to Rhode Island applicants. This company complies with Rhode Island law prohibiting smoking in enclosed areas within places of employment. Notice to North Dakota applicants: This company complies with North Dakota law prohibiting smoking within 20 feet of an entrance and inside places of employment. Notice to Indiana applicants: This company complies with Indiana law prohibiting smoking in enclosed areas within places of employment.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered.
DO NOT CHECK UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.*
- I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Confirming Date - Reading Applicant Statement*
Date Format: MM slash DD slash YYYY
Upload Your Resume
Please upload a PDF of your resume
Accepted file types: pdf.
AN EQUAL OPPORTUNITY EMPLOYER
After you click submit, a copy of your submission will be emailed to you.
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Dopkins & Co LLP

Full-service, accounting and consulting firm in Buffalo. We help clients grow and accumulate wealth with audit, tax, accounting professional services.

Dopkins Employment Application

Step 1 of 4

Application for Employment

Employment History

Additional Employment Information

Skills & Qualifications

Educational Background

References

Related Information

Applicant Statement

Upload Your Resume

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