Home Phone and Cell Phone

/ Information Request Form

Name

Address
(include city, state and zip)

Home Phone and Cell Phone

(include area code) / Home: Cell:
Work Telephone
(include area code)
Email Address
Permanent Address
(include city, state and zip)
Permanent Phone
US Citizen/Permanent Resident? Yes No If NO, type of Visa:______

Position You Are Applying For -- Please Check One in Each Category

Regular Full-Time / Intern

Start Date

Practice / Area of Interest

Regular Full Time

Fall

Audit

Intern

January (interns only)

Tax

/ /

Circle one: IRM IRBS IAS

College/University Information

Name of College/University : Month & Yr of Grad:

Degree/Major: Overall GPA: Major GPA:

Graduating with a Masters Degree or BS?

Will complete the required 150 semester/225 qtr hrs to take the CPA exam by (month & year):

SAT Scores English (200-800) Math (200-800) Composite (400-1600)

ACT Scores English (1-36) Math (1-36) Composite (1-36)

Please list your top one to two Geographic Location preferences. Please be specific and list the city where a KPMG office is located. (List Los Angeles, rather than Southern California). Briefly explain why you are interested in these locations.

Who referred you to us?

Have you previously applied for a position with us?

If yes: Year Office Position

Hours per week of outside employment during this academic year?

Visit our website at www.kpmgcampus.com. Thank you for your interest in KPMG.

KPMG LLP is an equal opportunity employer and does not discriminate in hiring on the basis of race, color, religion, sex, age, disability, national origin or veteran status.