Senior Employment Program Application

Applicants who are age 55 and older will be considered for placement opportunities without regard to race, color, religion, sex, national origin, marital status, veterans’ status, disability or other legally protected status. Responses to the following questions, together with information received from references or background checks, will not be used as a basis of discrimination but will be judged on the relevance of the information to the placement you seek.

Individuals with certain felony convictions are not permitted to be employed in private homes. The employer reserves the right to conduct criminal background checks.

Reference information must be accurate and complete for the Senior Employment Staff to conduct appropriate screenings. Please fill out as completely as possible.

Self Identification For Purpose Of Reporting Statistics To Funding Sources

As a recipient of government funds, we are required to comply with various requirements that require us to file annual statistical reports on applicants for the Senior Employment Program. Please be assured that you will not be subjected to any adverse treatment if you do not provide the information requested.

It is the intent and purpose of the Senior Employment Program to provide proper assistance, treatment, consideration, and/or services to all participants. The following outline should be followed by clients who feel they are not being served appropriately: 1. The participant should contact the Job Placement Specialist, explain their problem, and see if steps can be taken to alleviate their concern. 2. If the participant does not feel that progress was made, they can then request that a meeting be held between themselves, the JPS, and the Project Supervisor. 3. Should the situation still not be resolved to the client’s satisfaction, they should then appeal to the Executive Director. 4. Finally, should the situation continue to be unresolved, appeal can be made to the Department of Commerce, Topeka, Kansas.

To facilitate your appeal, it is preferable that appeals be made within three (3) working days of the original occurrence, and three (3) days consecutively following each step being followed. Response by Senior Employment Program to each step should be made within five (5) working days. The following information is the process by which appeals should be directed: 1. Senior Employment Director, Senior Services, Inc., 200 S. Walnut, Wichita, KS 67213; (316)267-1771 2. The Executive Director, Senior Services, Inc., 200 S. Walnut, Wichita, KS 67213; (316)267-0302. 3. Kansas Department of Commerce, 1000 SW Jackson Street, Suite 100 Topeka, KS 66612-1354 Phone: (785)296-7842 Fax: (785) 291-3512