Have you ever been convicted of breaking a law other than a minor traffic violation?*
Have you ever had an abuse or neglect or child maltreatment substantiation?*
Education - Choose the highest level of education you have completed.*
Educational, Vocational, Schools
May we contact the employer?
I certify that I have given true, accurate, and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration, and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigations of all statements made in this application and understand that false information of documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action, or dismissal if I am employed, and (or) criminal action. I further understand that dismissal on unemployment shall be mandatory if fraudulent disclosures are given to meet position qualifications.
