Yazoo City Employment Application

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. The City of Yazoo City is a “Drug Free Workplace.”

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Note: Application must be completed in entirety. Resumes may be submitted in addition to the completed application (email resumes to sharah.taylor@yazoocityms.us).

Employment Application

Application Info

Position(s) applied for (Required)

Date of application (Required)

Personal Information

First Name

Last Name

Physical Address (Required)

City (Required)

State (Required)

Zip Code (Required)

Telephone Number (Required)

Email Address (Required)

Eligibility

Are you a U.S. citizen or approved to work in the United States?

Yes

Are you 18 years of age or older?

Yes

Can you provide proof of citizenship or legal status?

Yes

Do you have a valid driver’s license?

Yes

If yes – Driver’s License STATE

If yes – Driver’s License Number

Are you currently employed?

Yes

May we contact your employer?

Yes

Availability

Available to work (select all that apply)

Full Time

Part Time

Shift Work

Temporary

If offered a position, when would you be able to start?

Previous Connection with City

Have you ever applied to or worked for City of Yazoo City before?

Yes

If yes, when?

Do you have any friends, relatives, or acquaintances working for City of Yazoo City?

Yes

If yes, name & relationship

Background

Have you ever been convicted of a felony within the last seven years?

Yes

If yes, explain. (Applicants are not obligated to disclose: (1) Sealed or expunged records of conviction or arrest; (2) Expunged juvenile records of conviction or arrest; or (3) a crime of which you have pleaded guilty, have reached supervision, have complied with court supervision, and have reached a judgement dismissing the charges.

Employment History 1

(Most Recent)

Employer Name

Employer Address

City

State

Zip Code

Employer Telephone

Dates Employed

Duties

Reason for leaving

Employment History 2

Employer Name

Employer Address

City

State

Zip Code

Employer Telephone

Dates Employed

Duties

Reason for leaving

Employment History 3

Employer Name

Employer Address

City

State

Zip Code

Employer Telephone

Dates Employed

Duties

Reason for leaving

Education

High School

Name

Location (City, State)

Year Graduated

College/University

Name

Location (City, State)

Year Graduated

Degree

Vocational School / Specialized Training

Name

Location (City, State)

Year Graduated

Certificate

Military

Are you a member of the Armed Services?

Yes

What branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Other Qualifications

Summarize special job-related skills, qualifications or additional information

Specialized Skills / Licenses (select all that apply)

Typing

Microsoft Office (PowerPoint, Excel, Word)

Other (Machinery / Mobile Equipment)

Describe specialized skills / licenses / machinery

References

Reference 1

Name

Phone

Address

Reference 2

Name

Phone

Address

Reference 3

Name

Phone

Address

Applicant’s Statement

I certify that the information I have entered on this form is true and complete to the best of my knowledge. I have read the minimum qualifications for this job and believe that I am qualified. I expressly authorize the City of Yazoo City or its agents to conduct any and all background investigations deemed necessary for the position applied. This application for employment shall be considered active for a period of time not to exceed 60 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I understand that if I deliberately conceal or enter false information on this form, that I may be removed from my job; that nothing contained in this employment application or in the granting of interview is intended to create a contract between me and the City of Yazoo City for either employment or the provision of any benefits; that information in this application may be released in an authorized legal investigation; and that for the purpose of this certification, a photo copy of my signature shall have the same force and effect as my original signature. I agree that the City of Yazoo City, or its agents, may contact current or former employers or other persons who know me in order to obtain additional information.

Type your full legal name as electronic signature (Required)

Date of Signature (Required)