Please note, this Mercer County is located in OHIO.

Read the Instructions Carefully
If the question does not apply to you, indicate with N/A. If space available is insufficient, please upload attachements as applicable. Do Not Misstate or Omit material facts, since the statements made herein are subject to verification to determine your qualifications for employment. NOTE: A Resume is encouraged but may not be used as a substitute for completing this application.

Personal Information:

E-mail Address
Telephone Number
Employment Desired
OPOTA Certification
Citizen Status
Drivers License Information