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Job Applications

All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring accommodation to complete the application and/or interview process should contact a management representative.

Position Applied For *

Date of Application *

Print Full Name *

Street Address *

Apartment/Unit/Suite

City *

State *

Zip *

Phone *

Email *

EMPLOYMENT EXPERIENCE

List the names of your present or previous employers in chronological order with present or
most recent employer listed first. Be sure to account for all periods of time. If self-employed,
give company name and supply business references. Add an additional page if necessary.

Name of employer *

Supervisor *

May we contact your previous supervisor for a reference? *

Yes

No

Street Address

Phone Number

From *

To *

Job Title and Duties

Reason For Leaving

Name of employer *

Supervisor *

May we contact your previous supervisor for a reference? *

Yes

No

Street Address

Phone Number

From *

To *

Job Title and Duties

Reason For Leaving

Name of employer *

Supervisor *

May we contact your previous supervisor for a reference? *

Yes

No

Street Address

Phone Number

From *

To *

Job Title and Duties

Reason For Leaving

Have you ever been involuntarily terminated or asked to resign from any job? *

Yes

No

If yes, please explain

Explain any gaps in your employment history.

List any other experience, job-related skills, additional languages, or other qualifications that you believe should be considered.

EDUCATION:

High School Name *

Degree or Diploma

Yes

No

Area of study/ major

Specialized training, skills, or extracurricular activities

College / University

Degree or Diploma

Yes

No

Area of study/ major

Specialized training, skills, or extracurricular activities

Graduate/ Professional School *

Degree or Diploma

Yes

No

Area of study/ major

Specialized training, skills, or extracurricular activities

Trade School

Degree or Diploma

Yes

No

Area of study/ major

Specialized training, skills, or extracurricular activities

Other

Degree or Diploma

Yes

No

Area of study/ major

Specialized training, skills, or extracurricular activities

Business and/or Professional References

Business and/or Professional References List three professional references of individuals who are not related to you.

Name and Title *

Relationship *

Phone Number or Email *

Name and Title *

Relationship *

Phone Number or Email *

Name and Title *

Relationship *

Phone Number or Email *

General Information

Have you ever used another name?

Yes

No

Is any additional information relative to name changes, use of an assumed name, or nickname necessary to enable a check on your work and educational record?

Yes

No

If yes to either of the above, explain:

Have you ever worked for this company before? *

Yes

No

If yes, please provide dates:

Do you have friends and/or relatives working for this company? *

Yes

No

If yes, name(s) and relationship(s):

On what date are you available to begin work?

Hours You Are Available To Work:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Are you available to work: *

Full Time

Part Time

Shift Work

Temporary

If hired, do you have a reliable means of transportation to and from work?

Yes

No

Can you travel if the position requires it?

Yes

No

Can you relocate if the position requires it?

Yes

No

Are you at least 18 years old? Note: If under 18, hire is subject to verification that you are of minimum legal age.

Yes

No

If hired, can you present evidence of your identity and legal right to work in this country?

Yes

No

. Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?

Yes

No

(Note: We comply with the Americans with Disabilities Act and consider reasonable
accommodation measures that may be necessary for qualified applicants/employees to
perform essential job functions.

Applicant Statement and Agreement

Read and initial each paragraph below. Ask if there is anything that you do not understand.

Initial *

I hereby authorize the company to thoroughly investigate my references, work record,
education and other matters related to my suitability for employment and, further,
authorize the prior employers and references I have listed to disclose to the company any
and all letters, reports, and other information related to my work records, without giving
me prior notice of such disclosure. In addition, I hereby release the company, my former
employers, and all other persons, corporations, partnerships, and associations from any
and all claims, demands, or liabilities arising out of or in any way related to such
investigation or disclosure.

Initial *

In the event of my employment with the company, I understand that I am required to
comply with all rules and regulations of the company

Initial *

If hired, I understand and agree that my employment with the company is at will and that
neither I nor the company is required to continue the employment relationship for any
specific term. I further understand that the company or I may terminate the employment
relationship at any time, with or without cause, and with or without notice. I understand
that the at-will status of my employment cannot be amended, modified, or altered in any
way by any oral modifications

Initial *

I understand that the safety of employees is extremely important to the company and that
the company is committed to ensuring a safe working environment. I understand that I,
and every employee, have a responsibility to prevent accidents and injuries by observing
all safety procedures and guidelines and following the directions of my site supervisor. I
understand and agree to comply with federal, state, and local regulations related to on the-job safety and health

Initial *

I hereby certify that the answers given by me are true and correct to the best of my
knowledge. I further certify that I, the undersigned applicant, have personally completed
this application. I understand that any omission or misstatement of material fact on this
application or on any document used to secure employment shall be grounds for rejection
of this application or for immediate discharge if I am employed, regardless of the time
elapsed before discovery.

Initial *

I understand that if I am selected for hire, it will be necessary for me to provide
satisfactory evidence of my identity and legal authority to work in the United States, and
that federal immigration law requires me to complete an I-9 Form in this regard.

Initial *

I understand that if any term, provision, or portion of this Agreement is declared void or
unenforceable, it shall be severed, and the remainder of this Agreement shall be
enforceable

My signature attests to the fact that I have read, understand, and agree to all of the above
terms.

Signature: *

Date: *

If you are human, leave this field blank.

Contact Us



706-672-8000



info@mss.inc



PO Box 452 Greenville Georgia 30222



20317 HWY 85 Suite D Gay Georgia 30218

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