Employment Application - St. Tammany Parish Government

St. Tammany Parish Government
Application for Employment
P.O. Box 628
Covington, LA 70434
985.898.3015
[email protected]
Date m
Position(s) applied for
First Name
Last Name
d
y
Middle Name
Street Address
State
City
Zip Code
AL
Telephone #
Alt. Telephone #
E-mail
Do you possess a commercial
driver's license?
Driver's License #
Yes
Class A
No
Class B
Can you upon hire provide proof of your legal right to work in the U.S.?
Are you over 18?
Yes
No
Yes
If not over 18, can you furnish a work permit?
No
Yes
If your application is considered favorable, on what date will you be available for employment?
m
d
y
Would you be willing to accept
Salary Desired?
Temporary
Have you ever been convicted of a felony?
Part Time
Yes
Full Time Employment?
No
If yes, please explain.
Education
Name and location of school
High School or GED
College
Other
Graduate
Years
Yes No
Attended
Course of Study
No
References
Name
Address
Telephone #
Employment History
Most recent employer
May we contact?
Yes
Telephone #
No
Beginning / Ending salary
Dates
employed
m
y
to
m
y
/
Address
Supervisor
Duties
Reason for leaving
2nd Most recent employer
May we contact?
Yes
Telephone #
No
Beginning / Ending salary
Dates
employed
m
y
to
m
y
/
Address
Supervisor
Duties
Reason for leaving
3rd Most recent employer
May we contact?
Yes
Beginning / Ending salary
Address
Duties
Reason for leaving
Telephone #
No
Dates
employed
m
y
to
/
Supervisor
m
y
Qualifications
List any skills, special training, professional licenses, certifications or qualifications which may
be of benefit in the job for which you are applying:
I hereby declare that the information provided by me in this Application for Employment is true
and correct to the best of my knowledge. I understand that if employed, any misstatement or
omission of fact on this application shall be considered cause for dismissal. I understand and
agree that this employment application, by itself or together with other company documents or
policy statements does not create a contract of employment. I also understand that I may
voluntarily leave or be terminated at any time for any reason if hired.
I HAVE READ AND AGREED TO THE ABOVE TERMS AND CONDITIONS.
Submit by Email
Print Form
EMAIL THIS APPLICATION ALONG WITH YOUR RESUME (if applicable) TO [email protected].