Application for Employment

Please use the form fields below to apply for a position with PSC of Yazoo City.

Fields marked with * are required.

Personal Information

Last Name *

First Name *

Middle Name *

Address

Street *

City *

State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip *

Email *

Phone No. *

Are you 18 years or older? * - Select -YesNo

Are you prevented from lawfully becoming employed in this country because of VISA or immigration status? * - Select -YesNo

Employment Desired

Position *

Date You Can Start *

Month MonthJanFebMarAprMayJunJulAugSepOctNovDec

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Year Year202320242025

Salary Desired *

Are you employed now? * - Select -YesNo

If so, may we inquire of your present employer? * - Select -YesNo

Do any of your friends or relatives, other than spouse work here? * - Select -YesNo

If so, please list their names *

Ever applied to this company before? * - Select -YesNo

Where? *

When? *

Referred by *

Education

High School

Name and location of school *

No of years attended *

Did you graduate? * - Select -YesNo

Subjects studied *

College

Name and location of school *

No of years attended *

Did you graduate? * - Select -YesNo

Subjects studied *

Trade, Business or Correspondence School

Name and location of school *

No of years attended *

Did you graduate? * - Select -YesNo

Subjects studied *

General

Subjects of special study or research work *

Other qualifications such as special skills, abilities or honors that should be considered *

Type of computers, software, and other equipment you are qualified to operate or repair *

Professional licenses or certifications *

Additional skills, including supervision skills, other language or information regarding the career/occupation you wish to bring to the employer's attention *

Activities (Civic Athletic, Etc.) Exclude organizations, the name of which indicates the race, creed, sex, age, marital status, color, or nation of origin of its members *

U.S. Military or Naval Service *

Military rank *

Present membership in National Guard or Reserves *

Leave this field blank