DistrictCampus
CAMPUS

Certified Job Application

APPLICATION FOR CERTIFIED PERSONNEL
USD 331 Kingman-Norwich
115 North Main - PO Box 416
Kingman, KS 67068


An Equal Opportunity Employer

USD 331 Kingman-Norwich is an Equal Opportunity Employer and does not discriminate o the basis of race, religion, color, national origin, sex, age, or disability.


Application for Certified Personnel

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Present Address

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Permanent Address

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Background Screening Authorization and Disclosure

As part of the application process for employment at USD 331 Kingman-Norwich, I understand that they and/or its agents may conduct an investigation of my personal information. The investigation might include, but is not limited to names and dates of previous/current employment, work experience, workers' compensation claims, criminal history records (from state, federal, and other agencies), motor vehicles, military records, names and dates of education, credit history, and bankruptcy records. I understand that these records may be used for the eligibility of my employment. I authorize without reservation the full release of these records and for National Screening Bureau and/or its agents contacted by National Screening Bureau to obtain information. In addition, I release and discharge National Screening Bureau, and all of its agents and associates, any expenses, losses, damages, liabilities, or any other charges or complaints for the investigative process. I also authorize the full release of the information described above, without any reservation, throughout any duration of my employment at the above state company. I also certify that all information provided is correct on the application and my resume to the best of my knowledge. Any false statements provided will be considered just cause for termination of employment. Upon Request, National Screening Bureau will supply a copy of my report and my rights under the Fair Credit Reporting Act. Requests may be directed to: National Screening Bureau, 920 N Tyler, Suite 302, Wichita, KS 67212 or by contacting us at 1-877-263-4405.




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Applying For: (Indicate grades/school subjects and/or administrative positions in order of preference)

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Professional Data - Kansas Licensure




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Chronological Teaching/Administrative Record

(Include Student Teaching)


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Other Work Experience

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Required Fields