• NORTHERN JACKSON COUNTY PUBLIC SERVICE DISTRICT

    "This is an equal opportunity provider and employer"
  • 39 Gilmore Drive
    Sandyville, WV 25275
    Phone: 304-273-9621

  • The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do SO. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the rate, ethnicity and sex of application on the basis of visual observation or surname.

  • Ethnicity:
  • Sex:
  • Race: (Mark all that apply)
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