SKIL was created by; is driven by; and is focused on persons with disabilities, their families, and communities. We provide Advocacy, Education,
and Support with Customer Controlled services to break down and remove existing barriers and bridge social gaps to ensure and preserve
Equality and Independence for all.

The SKIL Administrative Personnel Application

Southeast Kansas Independent Living Resource Center is an Equal Opportunity Employer
1. Date:
2. Position Applied for:
3.Last Name:
4.First Name:
5. Middle Name:
6. Address-Number and Street:
7. City - State:
8. Zipcode:
9. Home Phone:
10. Cell Phone:
11. Are you currently employed?:
12. May we contact your employer?:
13. Are you prevented from becoming lawfully employed in this country because of Visa or Immigration status? (Proof of citizenship or immigrstion status is reguired upon employment:
14. On what date would you be available for work?:
15. Would you be available to work:
Full Time
Part Time
16. Are you on layoff and subjest to recall?:
17. Can you travel if the job reguires it?:
18. Have you been convicted of a felony in the last seven years?:
19. (Conviction will not necessarily disqualify applicant from employment. If yes explain:
20. List professional, trade, business or civic activities and offices held. (You may exclude those which indicate race, color, religion, sex and national origin.:
21. Past Employer:
22. Street Address:
23. City, State, Zip Code:
24. Position/Title:
25. Most Recent Supervisor:
26. Dates employed:
27. Starting and Ending Salalry or Wage:
28. Reason for leaving:
29. 2nd Past Employer:
30. Street Address:
31.City, State, Zip Code:
32. Position/Title:
33. Most recent supervisor:
34. Dates employed:
35. Starting and Ending Salalry or Wage:
36. Reason for leaving:
37. 3rd Past Employer:
38. Street Address:
39. City, State, Zip Code:
40. Position/Title:
41. Most recent supervisor:
42. Dates Employed:
43. Starting and Ending Salary or Wage:
44. Reason for leaving:
45. 4th Past Employer:
46. Street Address:
47. City, State, Zip Code:
48. Position / Title:
49. Most recent supervisor:
50. Dates Employed:
51. Starting and Ending Salary:
52. Reason for leaving:
53. High School:
54. Complete Mailing Address:
55. Years Completed:
56. Major or Degree:
57. College:
58. Complete Mailing Address:
59. Years Completed:
60. Major or Dgree:
61. Graduate or Professional:
62. Complete Mailing Address:
63. Years Completed:
64. Major or Degree:
65. Business or trade School:
66. Complete mailing Address:
67. Years Completed:
68. Major or Degree:
69. Reference # 1:
70. Company:
71. Home address:
72. Daytime Phone Number:
73. Reference #2:
74. Company:
75. Home address:
76. Daytime Phone Number:
77. Reference #3:
78. Company:
79. Home Address:
80. Daytime Phone Number:
81. I hereby certify that the statements contained in this application are true and correct to the best of my knowledge and belief. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission on any information presented here is cause for immediate dismissal from SKIL Resource Center without any previous notice. Please enter your name:
82. I hereby give SKIL Resource Center permission to contact schools, previous employers (unless otherwise indicated), references, and others and hereby release SKIL Resource Center from any liability as a result of such contract. Please enter your name:
83.I acknowledge that any work that might be offered to an applicant by SKIL Resource Center is:
84. I also understand that SKIL Resource Center has a drug and alcohol policy that prohibits the use of drugs or alcohol on the job and that compliance with such policy is a condition of my employment. Please enter your name:
85. Date:
86. Your Email Address:
Attach File:
Send me a copy
* Required field


Time Sheet Submission

DSW Electronic Time Sheet Submission can now be done directly through the SKIL website. Take a photo of your time sheets and supporting documents and upload directly to the SKIL website at the DSW Submit Timesheet page.  There is a sub-menu link for it directly below the "DSW time sheets" menu located in the top menu and in the left menu of the home page.