Free Supplemental Employment Form - Kansas

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District of Kansas Supplemental Information Form
Last Name First Name Middle Name

Position Applying For: Can you travel if a job requires it?
Yes No

Are you able to perform the essential duties of the job for which you are applying?
Yes No

Salary Requirements:
Rate your foreign

$
FLUENT

Per Annum
EFFECTIVE LIMITED

language skills (other
than English)

SPEAK READ WRITE Check all applicable skills: Typing skills: W.P.M. cc:Mail Lotus Notes Transcribe from a recording device WordPerfect - version: PC skills Other software applications? List: