Jefferson Parish Juvenile Court

Employment Application

Jefferson Parish Juvenile Court is an Equal Opportunity Employer. Race, color, religion, age, sex, disability, marital or veteran status, place of national origin and other categories protected by law are not factors in employment, promotion, compensation or working conditions.

Position Applied For

Rate Of Pay Desired

Start Date

Last Name

First Name

Middle Name

Address

City/State

Zip Code

Home Phone

Cell Phone

Other Phone

Do you have the legal right to work in the United States?

Are you at least 18 years of age?

Do you have a valid driver's license?

State/License Number

Have you ever applied to, or worked for Jefferson Parish Juvenile Court?

Date Applied or Worked

Do you have any friends or relatives working for Jefferson Parish Juvenile Court?

Name and Relationship

How did you hear about us/this opening?

Do you or your spouse have any criminal or civil proceedings pending against you?

Details of Criminal or Civil Proceedings

Have you ever received a traffic citation or been involved in a traffic accident?

Traffic Citation or Accident Details

Have you ever been charged with, plead guilty or been convicted of a misdemeanor?

Misdemeanor Details

Have you ever pled guilty or no contest to, or been convicted of, a felony?

Note: Criminal convictions are not an absolute bar to employment. They will only be considered in relation to specific job requirements.

Felony Details - Include Jurisdiction (State and County)

Education and Training (include on-the-job training)

Education Level	School/Location	Course of Study	# of Years Attended	Degree
High School
Community College
Trade School
College/University
Seminars/Other

Military Service

Military Branch

Military Rank

Military Enlistment Date

Military Serial Number

Military Discharge Date

Military Discharge Type

Special Skills

Do you speak, write or understand any foreign languages?

Language(s)

Do you have any experience, training, qualifications or skills which you feel make you especially suited for work at Jefferson Parish Juvenile Court?

Details of Experience, Training, Qualifications or Skills

Computer Skill	Date (From - To)	Level Of Proficiency

Employment History

List all previous employers starting with your present or most recent position (last 10 years)

Previous Company

Company Name

Supervisor Name

Employment Date From

Employment Date To

Company Address

Company Phone

Salary

Position Duties

Reason For Leaving

Previous Company

Company Name

Supervisor Name

Employment Date From

Employment Date To

Company Address

Company Phone

Salary

Position Duties

Reason For Leaving

Previous Company

Company Name

Supervisor Name

Employment Date From

Employment Date To

Company Address

Company Phone

Salary

Position Duties

Reason For Leaving

Previous Company

Company Name

Supervisor Name

Employment Date From

Employment Date To

Company Address

Company Phone

Salary

Position Duties

Reason For Leaving

I am aware that any misrepresentations or falsifications made in connection with my obtaining employment with the Jefferson Parish Juvenile Court will be grounds for rejection or dismissal. The facts set forth in my application for employment are true and correct. I understand that, if employed, false statements on my application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal and financial records through any investigative agencies or bureaus of your choice. My signature below certifies that I have read and understand the terms and conditions outlined in this document. I agree and Submit my Form.

Course Title

Course Title

Course Title

Course Title

Course Title

Course Title

Employment Application

Education and Training (include on-the-job training)

Military Service

Special Skills

Employment History

Previous Company

Previous Company

Previous Company

Previous Company