Submit a Job Application

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Date (mm/dd/yyyy):
Position applied for:
Name: (First, Middle, Last)
Present Address: (Number & Street)
Zip Code:
Mailing Address: (Number & Street, City, State, Zip Code)
Telephone Number:
Social Security #: (Optional)
Are you eligible for employment in the U.S?
If hired, date available for work (mm/dd/yyyy):
Do you have a valid LA Driver's License?
Driver's License Number:
If yes, do you possess a CDL?
If yes, date issued (mm/dd/yyyy):
If yes, expiration date (mm/dd/yyyy):
Have you ever been convicted of any criminal offense other than minor traffic violations?
If yes, give dates and details of each conviction:
Were you ever employed by St. James Parish Government:
If yes, where?
List relatives currently employed by St. James Parish Government:
Special Skills/Licenses:
If other, explain:
List heavy equipment you can operate:
Computer Software Skills:
If other, explain:
Were you in U.S. Armed Forces?
If yes, please list the dates:
If yes, Branch:
If yes, Rank:
If yes, type of discharge recieved:
DD Form 214 Available:
Name of High School and last year completed
Name of College, years completed, and Course of Study
List all other Training/ Education:
          Please Include the Following:
  • Name & Address of Company 
  • Telephone Number
  • Start and End Dates
  • Hourly Salary 
  • Reason for Leaving
  • Name of Supervisor
  • Description of the type of work you did
Employment History: (List four most recent)
Have you ever been discharged from a job or forced or asked to resign?
If there is a particular employer(s), you do not wish us to contact, please indicate which one(s):
Additional information you wish to tell us about yourself:
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