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Fill in Your Mississippi Job Application Template

The Mississippi Job Application Form is a standardized document used by individuals seeking employment within the state of Mississippi. This form collects essential personal, educational, and work history information from applicants. Completing the form accurately is crucial for ensuring that your application is considered valid, so be sure to fill it out carefully.

To start your application process, click the button below to fill out the form.

Make This Mississippi Job Application

Fill in Your Mississippi Job Application Template

Content Overview

The Mississippi Job Application form serves as a crucial tool for individuals seeking employment within the state government. This comprehensive document requires applicants to provide personal information, including their name, contact details, and date of birth. It also prompts candidates to detail their educational background, asking about the highest level of education attained and whether they graduated from high school or received a G.E.D. Moreover, the form includes sections for applicants to outline their work history, specifying previous employers, job titles, and responsibilities. Important certifications and licenses must also be documented, with spaces allocated for the type of certification, issuing agency, and expiration dates. Additionally, applicants must answer agency-wide questions regarding their employment status with the state, military service, and demographic information. The application emphasizes the necessity of attaching a supplemental questions page, which is essential for the evaluation process. Failure to comply with this requirement can result in the application being deemed invalid. Lastly, the form includes a declaration section where applicants affirm the truthfulness of their provided information, highlighting the importance of accuracy and integrity in the application process.

Mississippi Job Application Preview

STATE OF M I SSI SSI PPI APPLI CATI ON

Re t u r n Com ple t e d Applica t ion t o: M ississippi St a t e Pe r son n e l Boa r d

210East Capit ol St reet , Suit e 800 Jackson, MS 39201

w w w . m spb. m s. gov

For St a ff/ Off icia l U se On ly

Re ce iv e d: __________________

I m por t a n t ! Ple a se Re a d Be for e y ou be gin t h e a pplica t ion pr oce ss:

Applica n t s m u st com ple t e a n d a t t a ch t h e “Su pple m e n t a l Qu e st ion s” pa g e w h e n a pp lica b le . This page is locat ed on t he MSPB

w ebsit e Job Openings scr een .

Scr oll dow n t o t he bot t om of t he scr een and click t he pr efer r ed j ob; w hen t he descr ipt ion is display ed,

click “ Pr int Job I nfor m at ion . ”

Applicat ions failing t o include t his page or lack ing sufficient infor m at ion w ill be r et ur ned t o t he applicant

as inv alid. Please ensur e y our applicat ion is r eceiv ed by t he closing dat e as indicat ed on t he j ob post ing.

- TYPE OR PRI N T I N BLACK I N K-

JOB I N FORM ATI ON

POSI TI ON # :

POSI TI ON TI TLE:

PERSON AL I N FORM ATI ON

FI RST NAME

MI DDLE I NI TI AL

LAST NAME

ADDRESS

CI TY

STATE

ZI P

HOME PHONE

ALTERNATE PHONE

MONTH AND DATE OF BI RTH

WHI CH METHOD DO YOU PREFER TO BE NOTI FI ED ABOUT YOUR

APPLI CATI ON STATUS?

EMAI L OR

PAPER

EMAI L ADDRESS

ED UCATI ON

WHAT I S YOUR HI GHEST LEVEL OF EDUCATI ON:

Som e High School

Som e College

Associat e’s Degree

Mast er ’s Degree

Doct or at e Degr ee

High School

Technical College

Bachelor ’s Degr ee

Specialist ’s

Degree

H I GH SCH OOL ED U CATI ON

DI D YOU GRADUATE FROM HI GH SCHOOL/ RECEI VE A G. E. D. ?

YES

I F NO, WHAT WAS THE HI GHEST GRADE LEVEL COMPLETED?

COLLEGE/ UN I V ERSI TY ED UCATI ON

SCHOOL NAME

DEGREE RECEI VED

DATES ATTENDED

DI D YOU GRADUATE?

SEMESTER

QUARTER

# OF UNI TS COMPLETED:

YES

SCHOOL LOCATI ON ( CI TY/ STATE)

MAJOR

SCHOOL NAME

DEGREE RECEI VED

DATES ATTENDED

DI D YOU GRADUATE?

SEMESTER

QUARTER

# OF UNI TS COMPLETED:

YES

SCHOOL LOCATI ON ( CI TY/ STATE)

MAJOR

SCHOOL NAME

DEGREE RECEI VED

DATES ATTENDED

DI D YOU GRADUATE?

SEMESTER

QUARTER

# OF UNI TS COMPLETED:

YES

SCHOOL LOCATI ON ( CI TY/ STATE)

MAJOR

REV 2/2012

CERTI FI CATES & LI CEN SES

TYPE	DATE I SSUED ( MONTH/ YEAR)	EXPI RATI ON DATE ( MONTH/ YEAR)

LI CENSE NUMBER	I SSUI NG AGENCY	SPECI ALI ZATI ON


TYPE	DATE I SSUED ( MONTH/ YEAR)	EXPI RATI ON DATE ( MONTH/ YEAR)

LI CENSE NUMBER	I SSUI NG AGENCY	SPECI ALI ZATI ON


TYPE	DATE I SSUED ( MONTH/ YEAR)	EXPI RATI ON DATE ( MONTH/ YEAR)

LI CENSE NUMBER	I SSUI NG AGENCY	SPECI ALI ZATI ON

W ORK H I STORY

DATES		EMPLOYER	POSI TI ON TI TLE
From	To

ADDRESS, CI TY, STATE

PHONE NUMBER		SUPERVI SOR ( NAME & TI TLE)

HOURS PER WEEK		SALARY	MAY WE CONTACT THI S EMPLOYER?
			YES	NO

DUTI ES


DATES		EMPLOYER	POSI TI ON TI TLE
From	To

ADDRESS, CI TY, STATE

PHONE NUMBER		SUPERVI SOR ( NAME & TI TLE)

HOURS PER WEEK		SALARY	MAY WE CONTACT THI S EMPLOYER?
			YES	NO

DUTI ES

REV 3/2012

W ORK H I STORY

DATES		EMPLOYER	POSI TI ON TI TLE
From	To

ADDRESS, CI TY, STATE

PHONE NUMBER		SUPERVI SOR ( NAME & TI TLE)

HOURS PER WEEK		SALARY	MAY WE CONTACT THI S EMPLOYER?
			YES	NO

DUTI ES


DATES		EMPLOYER	POSI TI ON TI TLE
From	To

ADDRESS, CI TY, STATE

PHONE NUMBER		SUPERVI SOR ( NAME & TI TLE)

HOURS PER WEEK		SALARY	MAY WE CONTACT THI S EMPLOYER?
			YES	NO

DUTI ES

REV 3/2012

AGEN CY W I D E QU ESTI ON S

1 . ARE YOU CURRENTLY EMPLOYED WI TH THE STATE OF MS? YES

2 . I F YOU ANSWERED “ YES” TO THE PREVI OUS QUESTI ON, I NDI CATE WHI CH AGENCY AND YOUR CURRENT JOB TI TLE. ( I F YOU PREVI OUSLY I NDI CATED “ NO” , PROCEED TO THE NEXT QUESTI ON. )

___________________________________________________________ _____________________________________________________________

		( AGENCY NAME)	( CURRENT JOB TI TLE)
3	. HAVE YOU BEEN SEPRATED WI THI N THE LAST 12 MONTHS FROM THE STATE OF MS DUE TO A REDUCTI ON I N FORCE ( RI F) ? YES				NO
4	. I F YOU ANSWERED “ YES” TO THE PREVI OUS QUESTI ON, I NDI CATE WHI CH AGENCY, YOUR PREVI OUS JOB TI TLE, AND THE DATE OF YOUR RI F
	SEPARATI ON. ( I F YOU PREVI OUSLY I NDI CATED “ NO” , PROCEED TO THE NEXT QUESTI ON. )
_______________________________________________			______________________________________	___________________________________
		( AGENCY NAME)	( PREVI OUS JOB TI TLE)	( DATE OF RI F)
5	. ARE YOU A VETERAN OF THE ARMED FORCES? YES		NO
	( I F YOU I NDI CATED “ YES” , YOU MUST ATTACH A COPY OF YOUR DD214 OR OTHER PROOF OF SERVI CES. )
6	. I F YOU ARE A VETERAN, WERE YOU DECLARED DI SABLED? YES NO
7 . ARE YOU AN ADULT MALE BORN ON OR AFTER JANUARY 1, 1960 WHO REGI STERED FOR SELECTI VE SERVI CE BETWEEN THE AGES OF 18 AND 25?
	YES	NO

TO M EET TH E REQUI REM EN TS OF FED ERAL REGULATI ON S, M SPB N EED S TO COLLECT I N FORM ATI ON ON TH E QUESTI ON S BELOW FOR REPORTI N G PURPOSES ON LY. TH I S I N FORM ATI ON W I LL N OT BE USED FOR M AKI N G EM PLOYM EN T D ECI SI ON S. ( OPTI ON AL)

8 . I NDI CATE YOUR RACE	9 . I NDI CATE YOUR GENDER	10 . AGE GROUP:
AMERI CAN I NDI AN	MALE	UNDER 18
AMERI CAN I NDI AN	FEMALE	18 - 25
WHI TE	FEMALE	18 - 25
WHI TE		26 - 39
HI SPANI C		26 - 39
HI SPANI C		40 - 54
BLACK		40 - 54
BLACK		55 - 69
ASI AN		55 - 69
ASI AN		70+
		70+
Ot her

AD D I TI ON AL I N FORM ATI ON

Addit ional I nfor m at ion ( ot her schools or t r aining; special qualificat ions; honors and aw ar ds; et c. ) :

APPLI CAN T D ECLARATI ON S

By signing t his applicat ion, I cer t ify t hat all st at em ent s m ade herein and on any at t ached docum ent s ar e t r ue and com plet e t o t he best of m y knowledge. I

aut horize t he ver ificat ion of t his infor m at ion by t he Mississippi St at e Per sonnel Boar d and any agency considering m e for em ploym ent . I	know t hat any
m isr epr esent at ion her ein m ay lead t o r ej ect ion of m y applicat ion, r em oval of m y nam e fr om t he list of eligibles, and/ or dism issal fr om	st at e ser vice. I

underst and t hat , as a condit ion of em ploym ent , I will be r equir ed t o pr esent docum ent at ion w hich verifies bot h m y ident it y and m y em ploym ent eligibilit y pur suant t o federal im m igr at ion law .

X _________________________________________________________________	_________________________________________________
SI GNATURE OF APPLI CANT	DATE

REV 3/2012

SU PPLEM EN TAL QU ESTI ON S

Applica n t s m u st com ple t e a n d a t t a ch t h e “Su pple m e n t a l Qu e st ion s” pa g e w h e n a pp lica b le . This page is locat ed on t he MSPB w ebsit e Job Openings scr een . Scr oll dow n t o t he bot t om of t he scr een and click t he pr efer r ed j ob; w hen t he descr ipt ion is display ed, click “ Pr int Job I nfor m at ion . ” Applicat ions failing t o include t his page or lack ing sufficient infor m at ion w ill be r et ur ned t o t he applicant as inv alid. Please ensur e y our applicat ion is r eceived by t he closing dat e as indicat ed on t he j ob post ing.

	AD D I TI ON AL W ORK H I STORY

	JOB I N FORM ATI ON
JOB NUMBER:		POSI TI ON TI TLE:

COLLEGE/ UN I V ERSI TY ED UCATI ON

SCHOOL NAME						DEGREE RECEI VED

DATES ATTENDED				DI D YOU GRADUATE?		SEMESTER		QUARTER
				YES	NO	# OF UNI TS COMPLETED:

SCHOOL LOCATI ON ( CI TY/ STATE)					MAJOR


SCHOOL NAME						DEGREE RECEI VED

DATES ATTENDED				DI D YOU GRADUATE?		DATES ATTENDED
				YES	NO

SCHOOL LOCATI ON ( CI TY/ STATE)					MAJOR

		CERTI FI CATES & LI CEN SES
TYPE				DATE I SSUED ( MONTH/ YEAR)			EXPI RATI ON DATE ( MONTH/ YEAR)

LI CENSE NUMBER				I SSUI NG AGENCY			SPECI ALI ZATI ON


TYPE				DATE I SSUED ( MONTH/ YEAR)			EXPI RATI ON DATE ( MONTH/ YEAR)

LI CENSE NUMBER				I SSUI NG AGENCY			SPECI ALI ZATI ON

			W ORK H I STORY
DATES		EMPLOYER				POSI TI ON TI TLE
From	To

ADDRESS		CI TY						STATE

COMPANY WEBSI TE		PHONE NUMBER				SUPERVI SOR ( NAME & TI TLE)

HOURS WORKED PER WEEK		MONTHLY SALARY				MAY WE CONTACT THI S EMPLOYER?
						YES	NO

DUTI ES

REV 3/2012

Get Mississippi Job Application File

File Features

Fact Name	Description
Governing Authority	The Mississippi Job Application form is governed by the Mississippi State Personnel Board (MSPB).
Submission Address	Completed applications must be returned to the Mississippi State Personnel Board at 210 East Capitol Street, Suite 800, Jackson, MS 39201.
Supplemental Questions	Applicants must complete and attach the "Supplemental Questions" page when applicable, which can be found on the MSPB website.
Application Validity	Applications lacking the supplemental page or sufficient information will be returned as invalid.
Notification Preference	Applicants can choose to be notified about their application status via email or paper.
Education Levels	The form allows applicants to indicate their highest level of education, ranging from some high school to a doctorate.
Work History	Applicants must provide details of their work history, including dates of employment, job titles, and responsibilities.
Veteran Status	Applicants are required to disclose if they are veterans and whether they have been declared disabled.
Signature Requirement	By signing the application, applicants certify that all statements made are true and authorize verification by the MSPB.
Deadline Compliance	Applications must be received by the closing date indicated in the job posting to be considered.

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