Employment Application

Burlington, KS

Program, services, and employment are equally available to everyone.
Please inform the Human Resources Department if you require accommodations for the application or interview.

Date of Employment
Date of Employment
Date of Employment
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquires of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools, or individuals from all liability when responding to inquires in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

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Using this form:

  • Please complete the form as thoroughly and accurately as possible. be sure to review your application before clicking ‘send’
  • do NOT press ‘enter’ when changing fields, this will submit your application prematurely.
  • there may be latency when submitting your application. if the system appears stuck, please be patient and wait for the system to provide feedback.
  • Do NOT click ‘send’ more than once. this may cause a blank application to be submitted