Employment Application - Kansas Department Of Administration Page 3

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Work Experience - List your last three employers or last three positions, starting with the most
recent.
Attach a Supplement to Employment Application or other pages if you want to include more positions.
□ Paid Employment
Month & Year
Name/Address of Employer
Reason for Leaving
□ Unpaid Experience
:
From
Full-time
Part-time
Number of hours per wk: _____
:
To
Ending Pay $_________ per_____
Title:
Duties:
_____________________________________________________________________________________
List Computer Skills used in this Position
__________________________________________________________________________________________________________________
Largest Number of People Supervised ______ Supervisor’s Name ___________________________________ Supervisor’s Phone Number
____________________
Month & Year
Name/Address of Employer
Reason for Leaving
□ Paid Employment
□ Unpaid Experience
:
From
Full-time
Part-time
:
To
Number of hours per wk: _____
Ending Pay $ ________ per_____
Title:
Duties:
_____________________________________________________________________________________
List Computer Skills used in this Position
__________________________________________________________________________________________________________________
Largest Number of People Supervised ______ Supervisor’s Name ___________________________________ Supervisor’s Phone Number
Month & Year
Name/Address of Employer
Reason for Leaving
□ Paid Employment
□ Unpaid Experience
:
From
Full-time
Part-time
Number of hours per wk: _____
:
To
Ending Pay $ ________ per_____
Title:
Duties:
_____________________________________________________________________________________
List Computer Skills used in this Position
__________________________________________________________________________________________________________________
Largest Number of People Supervised ______ Supervisor’s Name ___________________________________ Supervisor’s Phone Number
Page 3

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