Board Application

Note: If you are applying for the following, you are required to be a resident property taxpayer of that District:
  ·   St George Fire Protection District No. 2
  ·   Central Fire Protection District No. 4
  ·   Eastside Fire Protection District No. 5
  ·   Hooper Fire Protection District No. 6
  ·   Chaneyville Fire Protection District No. 7

An asterisk * indicates required field.

Please note that the Plan of Government - Sections 2.09, 2.13, 2.17, and 2.18 govern the Boards & Commissions.

Select the board you wish to apply for: *
First Name: *
Last Name: *
Middle Initial:
Name Suffix:
Residence Address:
Street Number: *
Street Name: *
Check if your street is not available.
City: *
State: *
Zip: *
-
Check if you would like to use a different mailing address.
Home Phone Number:
( ) -
Work Phone Number:
( ) -
Cell Number:
( ) -
Email Address:
Education: *
Work Experience: *
Other Qualifications: *
Date of Birth:
/ /
Race:
Sex:

* To apply you must be in compliance with Parts (C) and (D) of R.S. 42:2.1, which read:
C. No person owing any outstanding fines, fees, or penalties pursuant to the Code of Governmental Ethics shall be appointed to any board or commission of the state or any political subdivision.
D. For purposes of this section, "outstanding fines, fees, or penalties pursuant to the Code of Governmental Ethics" shall mean a fine, fee, or penalty equal to an amount of two hundred fifty dollars or more imposed by the Board of Ethics for which all appeals have been exhausted.
Yes, I am in compliance with the above.
No, I am not.

* In accordance with Section 2.09 of the Plan of Government, you must certify that you are a registered voter in East Baton Rouge.
Yes, I'm a registered voter in East Baton Rouge.
No, I am not.

For security purposes please type the numbers and decimals exactly how it appears in the box above.