Kansas Corps - Campus Leader Application

Contact Info

For a paper copy of this form click here.

(*= Required Field)

Full Name*

Street Address*

City*

State*

Zip*

Home Phone

Cell Phone

Email*

School

School Enrolled at*

Current Major*

GPA*

Current Hours Enrolled*

High School Attended*

Year of Graduation*

Written Responses

What Skills do you most enjoy using?

Why are you interested in this position?

What skills do you least enjoy using?

Discuss your past volunteer experiences and how they would relate to this opportunity?

Applicant Information

Are you a citizen of the United States?*

Yes No

If no, are you authorized to work in the U.S.?

Yes No

Have you ever worked for this company?*

Yes No

If so, when?

Have you ever been convicted of a felony?*

Yes No

If yes, explain?

Have you ever submitted to a background check?*

Yes No

If so, when and where?

How did you learn about the Kansas
Corps Campus Leader position?

If a person recommended you
please enter their name here

References

Please list two professional references.*

Full Name*

Relationship

Company*

Phone*

Address

Full Name*

Relationship

Company*

Phone*

Address

Work History

Company*

Phone*

Address

Supervisor*

Job Title

Starting Salary

Ending Salary

Responsibilities

Dates Employed

From
To

Reason for Leaving

May we contact your previous
supervisor for a reference?

Yes No

Company*

Phone*

Address

Supervisor*

Job Title

Starting Salary

Ending Salary

Responsibilities

Dates Employed

From
To

Reason for Leaving

May we contact your previous
supervisor for a reference?

Yes No

Agreement

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

I have read the agreement
and accept it. *