Welcome to Leavenworth County, KS

Position(s) Applied For:*

Job Openings*

Date of Application:*

Last Name, First Name, Middle Initial*

Address*

City, State, Zip Code*

Telephone Number(s), E-Mail Address*

If you are under 18 years of age, can you provide required proof of your eligibility to work?*

Yes

Have you been previously employed with Leavenworth County?*

Yes

If yes, give date

Are you currently employed?*

Yes

Do you have a valid driver’s license?*

Yes

Check your availability to work*

Full Time

Part Time

Shift Work

Temporary

On what date would you be available for work?

Are you currently or have you ever been a member of KPERS?*

Yes

Have you ever plead “guilty” or “no contest” to, been placed in a diversion program for, or been convicted of any crime other than a minor traffic violation? Answering “YES” to this question does not constitute an automatic bar to employment. Factors such as the date of the offense, seriousness and nature of the offense, rehabilitation and position applied for will be considered.*

Yes

Employment Experience Start with your present or last job. Include any job-related military service assignments or volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer, Phone

Address:

Job Title, Hourly Rate

Supervisor:

Reason for Leaving:

Hire Date:

Term Date:

May we contact employer?

Yes

Work Performed:

If you need additional space, please attach another page

Are you related to any county employee, appointed or elected official?

Yes

If yes, please identify the person and the relationship.

Online Application

COUNTY HOURS

COUNTY ADDRESS

COUNTY DIRECTORY!

Online Application

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