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
- 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)
- Are you 18 or older? (select one)
- 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)
- 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.Format: (000) 000-0000.
- Name of Immediate Supervisor
- Starting Date
  
  MonthDayYear
  Date
- Date of Separation
  
  MonthDayYear
  Date
- Position/Job Title
- Pay
- Reason for Leaving
- May We Contact?
- Prior Employer
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Name of Immediate Supervisor
- Starting Date
  
  MonthDayYear
  Date
- Date of Separation
  
  MonthDayYear
  Date
- Position/Job Title
- Pay
- Reason for Leaving
- May We Contact?
- Prior Employer
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- 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
- 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?
- Name of Program / Certification
- List any applicable special skills, training or proficiencies.
- 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: