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 Day Day12345678910111213141516171819202122232425262728293031 Year Year202220232024 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 EducationHigh 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
