Summer Worker Application

2017 College Student Summer Worker Program Application

Applications will not be accepted after Friday, April 21, 2017

St. James Parish Government

Timothy P. Roussel, Parish President

P.O. Box 106 Convent, Louisiana 70723-0106

(225) 562-2260

I hereby state that the information given is true in all respects. I understand that if I am employed and the information is found to be false, I will be subject to dismissal without prior notice.

I understand and agree that if St. James Parish Government offers employment, it will be for no definite term and may be terminated at any time, with or without cause and prior notice. I also understand that this status can only be altered by a written contract of employment, which is specific as to all material terms and is signed by the Parish President and me.


* In the position applied for text box, type "2017 Summer College Student Program" *

Position applied for:
Name: (First, Middle, Last)
Present Address: (Number & Street, City, State, Zip Code)
Mailing Address: (Number & Street, City, State, Zip Code)
Telephone Number:
Cell Number:
Are you eligible for employment in the U.S?
If hired, date available for work:
Do you have a valid LA Driver's License?
Driver's License Number:
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:
List relatives currently employed by St. James Parish Goverment:
Special Skills/Licenses: (Electrical, Mechanical, Clerical, Technology, CDL, Other-Explain)
List Heavy equipment you can operate:
If applying for an office position, list all Microsoft Office Software you have experience with: (Word, Excel, PowerPoint, Access)
Choose the last year completed of High School
Name of High School:
Year Completed High School (ex. 1990)
Choose the last year completed of College
Degree/Course of Study
Year Completed College:
List Other Training/Education: (Name of School, Degree, Year Completed)
List below present and past employment, beginning with your most recent: (Address and Phone Number of Company, Beginning and End Dates, Hourly Salary, Reason for Leaving, Supervisor, & Type of Work)
Name of Councilman
Today's Date (mm/dd/yyyy)
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