Employment Application

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Warren County E911 - Employment Application
Personal Information
Numbers only
Numbers only
Numbers only

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Position Applied For
Position Applied For

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Miscellaneous

Employment is subject to verification of minimum legal age.

Are you over 21 years of age?
Have you previously Applied for Employment with Us?

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Criminal

We conduct criminal background checks on job applicants prior to employment. In response to the following questions, all convictions of or pleas of guilty or no contest to criminal offenses must be disclosed. A conviction does not automatically mean you will not be hired. However, criminal background history, non-disclosure or inaccurate or misleading disclosure may result in a decision not to hire.

Have you ever been convicted of, or plead guilty or no contest (nolo contendre) to, a felony?
Have you been convicted of, or plead guilty or no contest (nolo contendre) to, a misdemeanor in the last 5 years, which resulted or could have resulted in incarceration?
Do you currently have any unresolved criminal charges pending (including DUI or DWI) but excluding minor traffic violations?
Are there any reasons for which you might not be able to perform the job duties (with a reasonable accommodation)?

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Education Information
Name and Location of College
Years of College Completed
Did you Graduate?
Degree or Diploma Awarded

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Education Information
Name and Location of College
Years of College Completed
Did you Graduate?
Degree or Diploma Awarded

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Education Information
Name and Location of High School
Years of High School Completed
Did you Graduate?
Degree or Diploma Awarded

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Trade School
Name and Location of Trade School
Years of Trade School Completed
Did you Graduate?
Degree or Diploma Awarded

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Military Service
Have you served in the U.S. Armed Services
Period of Service to
Period of Service to
Date of Final Discharge
Please Describe your duties and any special training you received

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Employment History
Numbers only
Employers Address
(Leave Blank if Currently Employed by this employer)
Name of Supervisor
Please list your job title and describe what your duties were
Why did you leave this employment?

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Employment History
Numbers only
Employers Address
Employed Start Date
Employed End Date
Supervisors Name
Please list your job title and describe what your duties were
Why did you leave this employment?

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Employment History
Numbers only
Employers Address
Employed Start Date
Employed End Date
Supervisors Name
Please list your job title and describe what your duties were
Why did you leave this employment?

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Employment History
Numbers only
Employers Address
Employed Start Date
Employed End Date
Supervisors Name
Please list your job title and describe what your duties were
Why did you leave this employment?

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Contact Employer

We may contact the employers listed above unless you indicate those you do not want us to contact.

Reason you do not want us to contact Employer

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References

Give below the names of three persons not related to you, whom you have known at least one year.

Numbers only
Numbers only
Numbers only

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Disclosure of Relatives

Our employees are required to list any known immediate or close family members who are also employed with us. Failure to do so will result in disciplinary action up to and including termination. Immediate family members are defined as, Mom, Dad, Sister, Brother, in-laws, Step – relations or spouse

List Name of Relative
mother, father, sister, brother, in-law, step father...
List the Department the relative is employeed in
List Name of Relative
mother, father, sister, brother, in-law, step father...
List Department Relative is Employed In
List Name of Relative
mother, father, sister, brother, in-law, step father...
Department Relative is employed in

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Legal

* Please Note that if you are selected for a position with Us, a backgrounds check as well as a drug / alcohol test will be done prior to employment.

** Please note that if you are selected for a position with us, Depending on the position you will be asked to provide information on your background and pertinent information regarding your employment and personal history.

By signing this Application I am certifying that

  • The Information provided in the application the Application for Employment is true, correct and complete. If employed and mis-statements or omissions of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.
  • If you decide to engage in an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so.
  • If a report is obtained you must provide, at my request the name and address of the agency so I may obtain from them the nature and substance of the information contained in the report.
Type your full legal name to Sign this application
Please enter the date you signed this application
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PUBLIC NOTICE

ROAD CLOSURE

The Warren County Road Department will close Warrior’s Trail at the intersection with Silver Creek Drive on Saturday, May 30, 2020 to allow work on the railroad overpass at that location. This area will be closed to traffic from 6:00 a.m. to 6:00 p.m.

2nd Congressional District Run Off Election POSTPONED

To slow the spread of the COVID-19 Governor Tate reeves issued an executive order to reschedule the run off election for June 23, 2020
 

MARRIAGE LICENSE REQUESTS

FOR ALL MARRIAGE LICENSE REQUEST PLEASE CALL OUR OFFICE AT 601-636-3961 FOR AN APPOINTMENT.   
PLEASE HAVE THE MARRIAGE LICENSE FORM FILLED OUT AND READY WHEN YOU COME IN

Bridge Closure

All County residents please be advised that beginning January 20, 2020 the existing bridge on Freetown Road near Greyline Drive shall be closed and traffic will be detoured around the bridge. The existing bridge is under contract to be replaced, and the contract allows for one hundred twenty (120) working days to complete the project. We apologize for the inconvenience, and ask for your patience while we improve the safety of this roadway and structure for the citizens of Warren County.