State Employee Application

CUSTOMER APPLICATION FOR STATE OF KANSAS EMPLOYEE

Your application will be reviewed and you will be notified within 1-3 business days. Upon approval, your login and password will be activated.

To get started, please fill out the Application Form below.
Required Fields are marked with *

Employee Name:

Employee State ID#:

Login Email:

Requested Password:

Agency Employed By:

Department:

Agency Address 1:

Agency Address 2:

City:

State:

Zip Code:

Daytime Phone Number:

Fax:

Employee Email:

Human Resources Email:

I hereby certify that I am a CURRENT employee of the State Of Kansas.

I understand that Kansas Correctional Industries and/or the State of Kansas cannot be held liable for any loss and/or damage to goods left on State property.

I understand that all goods and services are completed within State of Kansas correctional facilities by supervised offenders, not trained professionals.

I understand that Kansas Correctional Industries strives to provide quality goods and services, in a timely manner, to the best of our ability, in an effort to meet customer expectations.

I understand that all items must be picked up within thirty (30) days of notification of completion. Any items not picked up by the end of this thirty (30) day period will accrue a storage fee of $1.00 per square foot for an additional thirty (30) days.

I understand that any items not claimed within sixty (60) days of notification of completion will be returned to stock for resale.

I understand that Payment for goods and services will be made using a Debit/Credit Card; Cashier's Check or Money Order. NO CASH OR PERSONAL CHECKS will be accepted.

** Digital Signature of State Employee: (Type Name Below)

** Digital Signature Date:

Please type the letters and numbers below

**By typing your name and date above , you acknowledge this is your digital signature, and you are the person, whose name appears in the "Name" field of the above Application. By clicking the "Submit" button, you acknowledge you have read, accept, and will comply with the above disclaimer, and that all information is accurate.

Press your browser's print button to make a copy of this page for your records.

If you would have any questions, feel free to call our Customer Service at (913) 250-2692

or send an email to KDOC_KCI_Customer_Service@ks.gov

You can also drop us a line using our Contact Us page: Click here

CUSTOMER APPLICATION FOR STATE OF KANSAS EMPLOYEE

Call Customer Service at 913-250-2692 or E-mail at: KDOC_KCI_Sales@ks.gov