Knobbe, Martens, Olson & Bear, LLP
We consider applicants for all positions without regard to race, color, age, religion, sex, pregnancy, national origin, ancestry, citizenship, marital status, sexual orientation, gender identification, Vietnam era or disabled veteran status, medical condition, mental or physical disability or any other characteristic protected by state or federal law.

Date of Application: 02/09/2010

Position Information
Position Applied For: Patent Scientist
Office Location: Seattle

Personal Information
First Name: *
Middle Name:
Last Name: *
Email Address: (May we contact you via email?)
Street Address: * Apartment#
City: *
State: *
Zip Code: *
Country: *
Telephone: - (A telephone number or cell phone number is required.)
Cell Phone: -

Additional Information
If employed and you are under 18, can you furnish a work permit?
Have you filed an application here before?
*   (If Yes, give date)
Have you ever been employed here before?
  (If Yes, give date)
Are you employed now?
May we contact your present employer?
Are you legally eligible for employment in this country?
(Proof of legal right to work in the U.S. will be required upon employment.)
*
On what date would you be available for work?  
Are you available to work:
Are you on a lay-off and subject to recall?
Have you been convicted of a felony?
*  (If Yes, please explain:)
Have you been convicted of a misdemeanor within the last two years? (Conviction will not necessarily disqualify applicant from employment.)
*  (If Yes, please explain:)
Please indicate how you were referred to the Firm:
(e.g. newspaper advertisement, employee of Knobbe, Martens, Olson & Bear, LLP internet posting, etc.)
Publication/Employee/Site Name:   Date:

Education
  High School College / University Graduate / Professional
School Name
Years Completed
Diploma/Degree/Certificate
Education verification will be made for all positions requiring a degree and/or paralegal certificate.
If the name on your degree is different than your current name, please list that name:
Describe course of study in college/university or graduate/professional. Please limit entry to five lines.
Describe specialized training, apprenticeship and skills. Please limit entry to five lines.
State honors received or additional information you feel may be helpful to us in considering your application. Please limit entry to five lines.
List professional, trade, business or civil activities and offices held. (You may exclude memberships which would reveal your race, color, age, religion, sex, national origin, ancestry, citizenship, marital status, sexual orientation, gender identification, Vietnam era or disabled veteran status, medical condition including pregnancy, mental or physical disability or any other characteristic protected by state or federal law.) Please limit entry to five lines.
Tell us why you are interested in working at Knobbe, Martens, Olson & Bear, LLP. Please limit entry to five lines.

Employment Experience
Start with your present or most recent job. Include military service assignments and job related volunteer activities. You may exclude any organization names that indicate race, color, age, religion, sex, pregnancy, national origin, ancestry, citizenship, marital status, sexual orientation, gender identification, Vietnam era or disabled veteran status, medical condition, mental or physical disability or any other characteristic protected by state or federal law. (If you need additional space resubmit this form with name, address and e-mail address.)

Explain any gaps in employment in comments section below.
Comments:
Employer Name:
Address:
Phone: -
Job Title:
Last Supervisor:
Full Time or Part Time?
    From:   To:  
Length of Employment:      
    Start:   Final:  
Salary/Hourly Rate: $ $  
Work Performed:
Reason for Leaving:
(Be Specific)
Employer Name:
Address:
Phone: -
Job Title:
Supervisor:
Full Time or Part Time?
    From:   To:  
Length of Employment:      
    Start:   Final:  
Salary/Hourly Rate: $ $  
Work Performed:
Reason for Leaving:
(Be Specific)
Employer Name:
Address:
Phone: -
Job Title:
Supervisor:
Full Time or Part Time?
    From:   To:  
Length of Employment:      
    Start:   Final:  
Salary/Hourly Rate: $ $  
Work Performed:
Reason for Leaving:
(Be Specific)
Employer Name:
Address:
Phone: -
Job Title:
Supervisor:
Full Time or Part Time?
    From:   To:  
Length of Employment:      
    Start:   Final:  
Salary/Hourly Rate: $ $  
Work Performed:
Reason for Leaving:
(Be Specific)

Professional References
Provide information on three professional references who are not related to you.
Name:
Professional Affiliation:
Address:
Phone: -
Email Address:
Years Known:
Name:
Professional Affiliation:
Address:
Phone: -
Email Address:
Years Known:
Name:
Professional Affiliation:
Address:
Phone: -
Email Address:
Years Known:

Applicant's Statement
I certify that answers given herein are true and complete to the best of my knowledge.
Please answer Yes or No:
*
I authorize investigation of all statements contained in this application for employment as may be necessary to arrive at an employment decision.
Please answer Yes or No:
*
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time and reapply.
I understand that neither this document, nor any offer of employment from the Firm, constitutes an employment contract. I also understand that should I be employed by the Firm, such employment will be at will and may be terminated by me or by the Firm at any time, with or without cause or necessity of stating any reason and with or without advance notice and without liability for payment of wages or salary for any period after the date of such employment termination. This provision for at will employment supersedes any and all statements, promises or representations made to me on this subject matter, and may be changed only by a written agreement signed by me and the Firm's Managing Partner specifically so stating.
Please answer Yes or No:
*
I understand that failure to consent to all requirements outlined below will disqualify me from being considered for employment with the Firm.
I further understand that any offer of employment that may be made to me by the Firm is conditioned on my signing a separate Arbitration Agreement providing for final and binding arbitration of any disputes or claims that may arise between the Firm and me.
Please answer Yes or No:
*
In the event of employment, I understand that false or misleading information or material omissions given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations and policies of the Firm.
I have read and agree to the above "Applicant's Statement"
Please answer Yes or No:
*

Notifications to Candidate
Knobbe, Martens, Olson & Bear, LLP is dedicated to providing the highest quality of service to our clients, and we believe that substance abuse is incompatible with this goal. For this reason, we require all candidates for employment with the Firm to submit to and successfully complete a pre-employment drug screen for the presence of illegal drugs and controlled substances. All offers of employment are contingent upon successfully completing the drug screen. Candidates who refuse to take the pre-employment drug screen will not be hired by the Firm.
I have read and agree to the above "Notifications to Candidate"
Please answer Yes or No:
*

Consent to Background Check
I authorize the Firm or its agents to contact any of my prior employers, educational institutions, and professional references on this application form. I hereby release the Firm and all such prior employers, educational institutions, and professional references from any and all liability arising out of any request for, and disclosure of, such information.
I have read and agree to the above "Consent to Background Check"
Please answer Yes or No:
*

Notice to Applicant or Employee from Employer that Consumer Report May Be Obtained
In connection with your application for employment with the Firm, the Firm is requesting that AWSI Advanced Workplace Strategies, Inc. 17542 E. 17th Street, Suite 330 Tustin, CA 92780 714-731-3084, FAX 714-731-5569 perform an investigation of your background and check all consumer records available concerning your prior work history, driving record, criminal conviction record, credit history (if applicable), and other background information. In addition, the Firm may be requesting that the same agency prepare what is referred to as an investigative consumer report and which may include information regarding your character, general reputation, personal characteristics and mode of living.
The agency will issue a report containing the information discovered about you. You will automatically be provided a copy of any investigative consumer report within seven days after its receipt by the Firm.

Authorization of Applicant or Employee that Consumer Report May Be Obtained
I hereby authorize the Firm and AWSI Advanced Workplace Strategies, Inc., to investigate my background and obtain all available consumer reports about me.
I have read and agree to the above "Consent to Obtain Consumer Report"
Please answer Yes or No:
*   Date:

Authorization of Applicant or Employee that Employer is able to Respond to Requests for References
In the event I am hired, I authorize the Firm to respond to any requests for references it may receive either during my employment with the Firm or thereafter, by confirming the dates of my employment, the position(s) held or titles(s), and my salary/wage rate at the time any such request is received.
I have read and agree to the above "Authorization to Respond"
Please answer Yes or No:
* Date:

Federal Contractor Application Data
Knobbe, Martens, Olson & Bear, LLP (the "Firm") proudly provides legal services to various U.S. government agencies and contractors. As such, the Firm is considered to be a U.S. Government contractor, and Federal law requires that it request certain statistical data from qualified applicants who seek employment with the Firm. We would appreciate it if you would take a moment to complete this form and return it as indicated below. Please be assured that the information below will not be considered in the hiring process and if you are hired, the information will remain separate from your personnel files.

Optional Information: Completion of this portion of the form is optional.
Gender:
Male Female
What is your race/ethnicity?

Hispanic or Latino: a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

White (Not Hispanic or Latino): a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino): a person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino): a person having origins in any of the original peoples ofthe Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

American Indian or Alaska Native (Not Hispanic or Latino): a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.


IF YOU HAVE QUESTIONS REGARDING THIS OR ANY OTHER STATEMENT WITHIN THIS APPLICATION PLEASE ASK A FIRM REPRESENTATIVE , or (San Diego) BEFORE SUBMITTING.