Applicant Portal
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   Required Information
Login Information
 
 User Name     Must be at least 5 characters long
 Password     Password must meet the following requirements: Between 8 and 64 characters long, 1 capital letter, 1 number, 1 special character
 Confirm Password     Password must meet the following requirements: Between 8 and 64 characters long, 1 capital letter, 1 number, 1 special character
 
Personal Information
 
 First Name    
 Middle Name   
 Last Name    
 Address 1    
 Address 2   
 City    
 Province/State 
 Zip Code    
 Country 
  
 Email    
 Phone - Business   
 Phone - Mobile   
 Phone - Home    
 Phone - Fax   
 
Secondary Address
 
 Address 1   
 Address 2   
 City   
 Province/State   
 Zip Code   
 Country   
 
Optional Information
 
 Birth Date  Format mm/dd/yyyy
 Employee Number 
 Social Security No.  Format numeric only
 
Disclosure Statement
The tremendous responsibility the school district has to its school children and community necessitates the following information from all applicants regarding convictions. A record of conviction does not prohibit employment; however, failure to complete this form accurately and completely may mean disqualification from consideration for employment or may be cause for dismissal if employed. Applicants must report any convictions that occur subsequent to the time they initially complete this form.

CONVICTION OF A CRIME IS NOT AN AUTOMATIC BAR TO EMPLOYMENT. CONVICTIONS OR PENDING CHARGES WILL NOT BE USED OR CONSIDERED UNLESS THEY ARE SUBSTANTIALLY RELATED TO CIRCUMSTANCES OF THE PARTICULAR JOB.
 
I have read the above statement.
 
 

Has your administrative certificate/license or teaching certificate/license, in any state, ever been annulled, suspended or revoked?
 
 

If yes, please explain:
 

Have you been convicted of a felony or misdemeanor (other than minor traffic offenses)?
 
 

Have you ever been dismissed from any position for immoral or unprofessional conduct or for unfitness for service?
 
 

If your answer if 'yes' to either of the above questions, please provide complete details below stating date, circumstances, place, action taken, etc.
 

 
Employer Questions
USD 443 does not discriminate on the basis of race, color, national origin, sex, age, religion, military status, primary language, and/or disability. This non-discrimination policy applies to admission, employment, programs, activities, and providing equal access to Boy Scouts and other designated youth groups. A lack of English language skills will not be a barrier to admission and participation in the Career and Technical (vocational) and/or other educational programs of the school. Any demographic information will not be visible to the hiring team during the selection process to ensure that the process is fair to all applicants. If you have questions regarding the above, please contact the Human Resources Director, 1000 N. Second Avenue, Dodge City, KS 67801, 620-371-1004.
 
Are you currently employed by USD 443?
 
 

If yes, list building and postion.
 

If no, have you ever been employed by USD 443?
 
 

Best time for us to contact you via telephone. List best telephone number.  
 

Are you bilingual - English/Spanish?
 
 

Date available for work.  
 

Are any of your relatives currently employed by USD 443?
 
 

If yes, list relationship and position.
 

Were you or are you currently a member of the armed forces of the United States or of a state militia?
 
 

How did you learn of this job opening?  
 

If you have learned of this job opening through another media, (not listed above), please indicate resource's name.
 

  
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