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Employment Application

Education and Professional Certificates - Provide information on your highest degree of education and list any certifications that would relate to the position you are applying for.

Employment History - Complete this section by listing your most recent employment information first.

Date Hired
Month
Day
Year
Date Job Ended
Month
Day
Year

Date Hired
Month
Day
Year
Date Job Ended
Month
Day
Year

Date Hired
Month
Day
Year
Date Job Ended
Month
Day
Year

References - Complete contact information for two work related/professional references.

Driver's License and Transportation

I attest that I have a valid driver's license and reliable transportation to and from work. Initial by your response.

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Driver History Consent (MVR Release)

I consent to the release of my Motor Vehicle Records (MVR) to Mid-South Construction Services. I understand the company will use these records to evaluate and review my driving record to fulfill driving duties that are related to the position for which I am applying. Initial by your response.

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Criminal Background

In the interest of maintaining safety and security of our customers, employees, and property and to maintain the integrity of our company, Mid-South Construction Services will order a "criminal background check" as part of our interview process. Below you will have an opportunity to explain anything that may arise during a criminal background check. Any discrepancies that are reported to us will require a written explanation and may result in termination.

Have you ever been convicted of a felony?
Yes
No

Drug Testing

I hereby give my consent to authorize Mid-South Construction Services and the testing laboratory to determine the absence or the presence of Class A Drugs (heroin, cocaine, etc.) and/or Class B Drugs (cannabis, amphetamines, etc.) in my body through the use of urine, hair, blood, or breath analysis. I give my consent to release the results of the test(s) from the laboratory to my employer and I understand that the results show the presence of drugs in my body will result in termination of employment.

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Date
Month
Day
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Main Office

Mid-South Construction Services

340 Pierce Rd.

Oakland, TN 38060

Inquiries

For any inquiries,

questions or commendations, please call: 901-743-0342

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