County Commission Meeting May 3, 2021

Mystic Water Maintenance Request

Road Concerns Form

General Employment Application

Date / Time *

Phone Number *

Full Name *

Address *

Email *

Most Recent Employer *

Phone Number *

Supervisor *

Address *

Start Date-End Date *

Position and Salary *

Reason for Leaving *

Other Employment

Phone Number

Supervisor

Address

Start Date-End Date

Position and Salary

Reason for Leaving

Other Employment

Phone Number

Supervisor

Address

Start Date-End Date

Position and Salary

Reason for Leaving

Other Employment

Phone Number

Supervisor

Address

Start Dater-End Date

Position and Salary

Reason for Leaving

Reference #1 *

Address *

Phone Number *

Business *

Years Acquainted *

Reference #2 *

Address *

Phone Number *

Business *

Years Acquainted *

Reference #3 *

Address *

Phone Number *

Business

Years Acquainted *

Emergency Contact: *

Relation (Relative, Family Friend, Co-Worker, etc.): *

Phone Number *

Address *

By typing your name in this box, you are authorizing an investigation of all statements contained in this application. You also understand that misrepresentation or omission of facts is cause for dismissal. Further, You understand and agree that your employment if for no definite period of time and that you may be terminated at any time without prior notice regardless of the date of payment of your wages and salary. *

Board of Roads & Revenues Application for Employment

Date / Time *

Name *

Email *

Present Address *

Number *

Are you legally eligible for employment in the USA? *

Yes
No

Are you of the legal age to work? *

Yes
No

Position applied for *

Do you have a CDL License? *

Yes
No

If no, are you willing to apply for them? *

Were you previously employed by us? *

Yes
No

If Yes, when?

Date / Time *

Are there any other experiences, skills or qualifications which will be of special benefit in the job for which you are applying?

Elementary Education: Name and Address of school, start date-end date, and did you graduate?

High School Education: Name and Address of school, start date-end date, and did you graduate?

College Education: Name and Address of school, start date-end date, and did you graduate?

Any other schools attended or classes taken?

Most Recent Employer: *

Phone Number: *

Supervisor *

Address *

Start Date-End Date *

Position and Salary *

Reason for Leaving *

Describe the work that you did: *

Other Employment: *

Phone Number: *

Supervisor *

Address *

Start Date-End Date *

Position and Salary *

Reason for Leaving *

Describe the work that you did: *

Personal Reference Name *

Address *

Phone Number *

Years Known *

Personal Reference Name *

Address *

Phone Number *

Years Known *

Personal Reference Name *

Address *

Phone Number *

Years Known *

By typing your name below, you hereby give permission to contact the employers listed above concerning your prior work experience *

Comment

Irwin County

County Commissioners
207 S Irwin Ave
Ocilla, GA 31774

Scott Carver
Chairman

Aldene Tyson
Vice Chairman

Barron Jones
Chairman

Chris Paulk
Chairman

Jimmy Mobley
Chairman

Warren Mixon
County Attorney

Patricia Battle
County Clerk

Luke Roberts
Ocilla Star

Regularly Monthly Meeting of the Irwin County Commissioners held on May 3, 2021 at the Irwin County Courthouse at 6:00 p.m.

Call to Order

Invocation

Pledge of Allegiance

Approval of Agenda/or Agenda Changes

Acceptance of Minutes

Old Business

New Business

Public Comments

Chairman Report

District Report

Executive Session-As Needed

Adjourn

County Commissioners207 S Irwin AveOcilla, GA 31774

Scott CarverChairman

Aldene TysonVice Chairman

Barron JonesChairman

Chris PaulkChairman

Jimmy MobleyChairman

Warren MixonCounty Attorney

Patricia BattleCounty Clerk

Luke RobertsOcilla Star

Regularly Monthly Meeting of the Irwin County Commissioners held on May 3, 2021 at the Irwin County Courthouse at 6:00 p.m.

Call to Order

Invocation

Pledge of Allegiance

Approval of Agenda/or Agenda Changes

Acceptance of Minutes

Old Business

New Business

Public Comments

Chairman Report

District Report

Executive Session-As Needed

Adjourn

County Commissioners
207 S Irwin Ave
Ocilla, GA 31774

Scott Carver
Chairman

Aldene Tyson
Vice Chairman

Barron Jones
Chairman

Chris Paulk
Chairman

Jimmy Mobley
Chairman

Warren Mixon
County Attorney

Patricia Battle
County Clerk

Luke Roberts
Ocilla Star