Employment Forms
Welcome to Bluestem USD No. 205. We hope that you will find your employment in the district both rewarding and fulfilling. In order to add you as an employee, several forms must be completed and returned to the Central Office, 711 N. West Street, Leon, Kansas.
The following forms need to be completed:
See the end of this article for links to the downloadable forms...
Employee Information—Include a copy of the following
Birth Certificate
Driver’s License
Social Security Card
Marriage License (Full-time employees only covered by KPERS)
Copy of Transcript (Full-time teacher and administrators)
Copy of Teaching Certificate (Teacher, Administrators, and Substitutes)
Employee Emergency Care Plan
Oath of Officer or Employee
The state requires that the district have an oath of office for each employee on file
If you sign the form at the Central Office it can be notarized by the Board Clerk
Health Certificate
The health certificate must be completed by a Health Care Professional. The form
can be completed by your physician or if you choose the form may be completed
by Bi-County Health in either El Dorado or Augusta.
In the event you have a completed health form please submit copy to the Central Office.
Withholding Forms for Federal and State Withholding
I-9’s
Complete section 1 only
KPERS
KPERS 1 needs to be completed by all new employees to the district covered by KPERS.
KPERS 7 need to be completed all new enrollees into KPERS or if you wish make a change in your beneficiaries.
KPERS 79 needs to completed if you are transferring optional life insurance coverage from another agency.
Background Check Form
Complete and return to Central Office
Pre-employment Drug Screening
Upon employment you will be given a form by the central office that will require you to provide a urine sample at HR Solutions, LLC in ElDorado within 24 hours of the time and date listed on the form given you at the central office.
Any time you have a change in any of the information listed above please contact the Central Office.
Time card cut off on the 10th of each month with checks being issued on the 20th unless the 20th falls on the weekend check will be issued on Friday.
Full time employees should contact, Ava McHone, Central Office, 742-3261 regarding other payroll deductions. i.e. Health, life, cancer, accident and disability insurance,; annuities; Section 125 benefits, and all other available payroll deductions.
If you have any questions regarding any of the forms please contact Ava McHone at 742-3261.
Forms Necessary for New Employees:
- Employee Information Form
- Background Check Form & Rights
- Pre-employment Drug Screening Form
- Employee Emergency Care Plan
- Federal I-9 Employment Eligibility Verification Form
- Federal W-4 Income Tax Withholding Form
- Kansas Oath of Office Form
- Kansas Certification of Health Form
- Kansas K-4 Tax Withholding Form
- KPERS 1 Report of Member Status Form
- KPERS 7 Designation of Beneficiary Form
- KPERS 79 Optional Group Life Insurance Transfer Form
- Direct Payroll Deposit Form
