Concordia Parish Application For Employment

Application For Employment
CONCORDIA PARISH POLICE JURY

4001 CARTER ST, RM. 1

VIDALIA, LA 71373

PHONE: 318-336-7151

FAX: 318-336-9915

AN EQUAL OPPORTUNITY EMPLOYER

It is our policy to comply fully with all federal, state and local equal employment opportunity laws. This organization provides equal employment and advancement opportunities for all persons regardless of race, creed, sex, national origin, age, religion, disability, marital status, sexual orientation or any other classification protected by law.

The following policy decisions of the Concordia Parish Police Jury are recorded for information and guidance of applications.

1. All prospective employees must have a physical examination before being employed.

2. Notice of Legal garnishment proceedings against a Police Jury employee wages may be cause for dismissal.

3. All applicancts driving records will be checked.

4. The Police Jury has a drug-free workplace policy and any Police Jury employee may be picked at random at various times to be tested for drug use or may be requested to take a lie detector test.

5. This application will be on file in the Concordia Parish Police Jury Office for a period of six months, at which time, it will be discarded unless the applicant returns to update the application.

6. If hired, you will be required to perform all functions as directed by your Supervisor. The task may be outside your direct position. Your Supervisor has the ultimate authority to add to the job duties that best meets the needs of the Parish as he/she sees fit.
FULL NAME*

First NameMiddle NameLast Name
POSITION APPLIED FOR:*
How did you hear about this position?*
DATE*

MonthDayYear
Date

Click here if you are you applying for a Clerical Position?
CLERICAL APPLICANTS

MUST BE ABLE TO LIFT 30 POUNDS OR MORE, TYPE AT LEAST 50 WPM, OPERATE MICROSOFT OFFICE AND QUICKBOOKS, OR HAVE A COMPETENT KNOWLEDGE OF THE ABOVE PROGRAMS.
Please list any specialized skills:
How Many WPM (at your last timed writing):
What Computer Programs have you used:

Personal Information
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Mobile Phone Number*

Area CodePhone Number
SSN#*
Email Address*
example@example.com
Are you entitled to work in the United States (select one)*

yesno
Are you 18 or older? (select one)*

yesno
If you are 18 or older provide your date of birth.*

MonthDayYear
Date
Have you been convicted of a felony or been incarcerated in connection with a felony in the past seven years? (select one)*

yesno
If you have you been convicted of a felony or been incarcerated in connection with a felony in the past seven years please explain:
Military Service?*
Are you a War veteran?*
Upload a copy of a valid driver's license

Cancelof
Upload Your Resume

Cancelof
Expected Hourly Rate*
Expected Weekly Earnings*
Available Start Date*

MonthDayYear
Prior Work Experience
Current or Most Recent Employer*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Name of Immediate Supervisor*
Starting Date*

MonthDayYear
Date
Date of Separation*

MonthDayYear
Date
Position/Job Title*
Pay*
Reason for Leaving*
May We Contact?*

yesno

Click if you have a Prior Employer
Prior Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Name of Immediate Supervisor
Starting Date

MonthDayYear
Date
Date of Separation

MonthDayYear
Date
Position/Job Title
Pay
Reason for Leaving
May We Contact?

yesno

Click if you have a Prior Employer
Prior Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Name of Immediate Supervisor
Starting Date

MonthDayYear
Date
Date of Separation

MonthDayYear
Date
Education
Name of High School*
City & State of High School*
Last Year Completed*
Did You Graduate*

yesno
Area of Emphasis
Name of College / University
City & State of College / University
Last Year Completed
Highest Degree Earned
Major or Emphasis
Name of Trade School
City & State of Trade School
Last Year Completed
Did you complete the program?

yesno
Name of Program / Certification
List any applicable special skills, training or proficiencies.

Click here if you are related to anyone in our employ
Name of Relative Number One
Department / Position of Relative Number One
Name of Relative Number Two
Department / Position of Relative Number Two
Name of Relative Number Three
Department / Position of Relative Number Three
Disclaimer

By typing my name, I hereby certify that the above information, to the best of my knowledge, is correct. I undeerstand that falsification of this information may prevent me from being hired or lead to my dismissal if hired. I also provide consent for fomer employers to be contacted regarding work records.
Type Your Name*
Today's Date*

MonthDayYear
Date

Should be Empty: