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Boards and Commissions Application Form

    We consider applications for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job related medical condition or handicap, or any other legally protected status.

    (Please Note: All information must be supplied in order for application to be considered by Appointments Review Board)

    If you would like to submit a physical application you can download the form here (PDF).
  2. Appointment Requested
  3. Are you currently serving on any board/commission?*
  4. Are you currently employed by St. Bernard Parish Government?*
  5. Are you an elected or appointed official?*
  6. Are you a registered voter in St. Bernard Parish?*
  7. Have you been convicted of a felony within the last seven (7) years?*
  8. Education
  9. Employment
    List the last two employers, starting with the last/present one first.
  10. References
    Give the names of three persons, not related to you, whom you know for at least one year.
  11. Agreement*
    I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for appointment as may be necessary in arriving at an appointment decision. This application for appointment shall be considered active for a period of time not to exceed one (1) year. Any applicant wishing to be considered for appointment beyond this time should inquire as to whether or not applications are being accepted at that time.

    By submitting this form, I understand that I am submitting to a background check by St. Bernard Parish Government.

  12. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  13. Leave This Blank:

  14. This field is not part of the form submission.