2. 

4. City of McPherson, Kansas 

6. APPLICATION FOR TEMPORARY/SEASONAL EMPLOYMENT

8. Date*
9. Department *
11. Name (First middle last) *
13. Position Desired*
15. Street Address*
16. City, State, Zip Code*
18. Best contact phone number *
19. Email address*
23. Are you at least 18 years of age?
    -- Select One --YesNo
25. Schools attended other than high school
27. School
28. Course studied
29. Degree or certificate
33. Special qualifications and Skills (licenses, skills, equipment, computer skills, etc.)
37. Experience: Present or last job and work back
39. Employer
40. Telephone #
41. Dates of employment
43. Job title
44. Supervisor
46. Reason for leaving
47. Hourly pay
49. Describe duties and responsibilities
53. Employer
54. Telephone #
55. Dates employed
57. Supervisor
58. Hourly rate/salary
60. Reasons for leaving
62. Describe duties and responsibilities
66. Employer
67. Telephone #
68. Dates employed
70. Supervisor
71. Hourly rate/salary
73. Reasons for leaving
75. Describe duties and responsibilities
79. Do you have a valid Kansas Drivers License?
    -- Select One --YesNo
80. Drivers License #
81. Do you have a CDL?
    -- Select One --YesNo
83. If you have a CDL, list the types of endorsements you have.
85. If selected for employment, you must notify your supervisor within 30 days of a conviction for any traffic violation (except parking), no matter what type of vehicle you were driving; and if your license is suspended, revoked or cancelled, or if you are disqualified from driving.
89. Have you ever been convicted of an offense against the law or forfeited collateral, or are now under charges for any offense against the law? You may omit: Any offense committed before you 21st birthday which was finally adjudicated a juvenile court or under a Youth Offender Law.
    -- Select One --YesNo
91. If your answer is yes, give details below. NOTE: A conviction does not automatically mean you cannot be considered. What you were convicted of an how long ago, are important. Give all of the facts so that decisions can be made.
95. Certification

    I certify that all of the statements made in this application are true, complete and correct to the best of my knowledge and belief are made in good faith. Printed applications are available at the Municipal Center, 400 E. Kansas Ave. Those applying digitally will be asked for signature and social security number upon interview request. 

97. Signature*
98. Date Signed*
    Date Signed
100. Click here for a printable application to fill out.

     Printable application.

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102. Submit

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