EMPLOYMENT INFORMATION
POSITION TYPE
WHAT IS YOUR ASSOCIATED HIGH SCHOOL?
PERSONAL INFORMATION
LEGAL FIRST NAME
PREFERRED NAME
LEGAL MIDDLE NAME
LEGAL LAST NAME
DATE OF BIRTH (Ex. 01/15/2020)
SOCIAL SECURITY NUMBER
DRIVER'S LICENSE NUMBER
DRIVER'S LICENSE EXPIRATION DATE (Ex. 01/15/2020)
PERSONAL EMAIL ADDRESS
PHONE NUMBER
MAILING ADDRESS
STREET ADDRESS
CITY
STATE
ZIP CODE
EMERGENCY CONTACT INFORMATION
NAME
RELATIONSHIP
STATISTICAL INFORMATION
GENDER IDENTITY (OPTIONAL)
PRONOUNS (OPTIONAL)
LEGAL SEX (OPTIONAL)
SEX AT BIRTH (OPTIONAL)
ETHNICITY (OPTIONAL)
RACE (OPTIONAL)
DO YOU SPEAK ANY OTHER LANGUAGES THAN ENGLISH? (OPTIONAL)
WHICH LANGUAGES CAN YOU SPEAK? (OPTIONAL)
EDUCATIONAL INFORMATION
WHAT IS YOUR HIGHEST LEVEL OF EDUCATION ACHIEVED?
WHAT IS YOUR AWARDING INSTITUTION?
HOW MANY CREDIT HOURS HAVE YOU COMPLETED?
KPERS INFORMATION
ARE YOU A CURRENT KPERS MEMBER?
WHAT YEAR DID YOU START?
ARE YOU A KPERS RETIREE?
WHAT DATE DID YOU RETIRE?
Created
Staff Member to Process