*
No
Yes
Have you ever been subject to any disciplinary action (including discharge) or investigation by a church, religious, other organization or by an employer?
*
None
Yes
Describe any conditions or limitation that might restrict or prevent you from performing the required activities involved in the position you are applying for (i.e lifting, handling an emergency, driving, participating in certain sports).
*
No
Yes
Have you ever been convicted of a criminal offense (felony or misdemeanor, except minor traffic violations)? You will need to answer "Yes" if you have entered into a plea agreement, including deferred sentences or deferred judgement arrangements in court.
If you have been convicted of such an offense, please provide a statement of explanation, including the nature of the the offense, date, court where conviction was entered and any other relevant information.*
If you have been convicted of such an offense, please attach a statement of explanation, including the nature of the offense charged, date, law enforcement agency making the charge and any other relevant information.*
Have you ever been reported to a social agency, law enforcement authority, child abuse registry or similar organization regarding abuse or misconduct involving children?*
No
Yes