Do you possess a driver license? If yes, list state and license number: Have your driving privileges ever been canceled, suspended, or revoked? If yes, explain: 20a. Have you ever used, or experimented with any illegal drug? If yes, explain: b. Have you ever sold, delivered, manufactured, smuggled, trafficked in illegal substances or drug paraphernalia? c. Have you ever possessed illegal substances or drug paraphernalia? 21a. Have you ever been convicted of a felony or a misdemeanor? b. Have you ever pled Nolo Contendere or pled guilty to a which is a felony or a misdemeanor? c. Have you ever had the adjudication of guilt withheld for a crime which is a felony or a misdemeanor (including sealed records)? d. If you answered "Yes" to 21 a, b, or c, complete the following: Date Place Agency Charge Disposition Details Are you or have you ever knowingly been under investigation by any local, state, federal agency, or entity for any wrongdoing either administrative, civil or criminal? If yes, explain: Have you ever committed a crime, whether arrested or not, that would constitute a felony or a misdemeanor? Yes No Have you ever been civilly or administratively adjudicated guilty to have engaged in any sexual abuse or sexual harassment? Have you now or have you ever had any affiliation with a known threat group “gang”? If so, describe the circumstances in detail.
Do you possess a driver license? If yes, list state and license number: Have your driving privileges ever been canceled, suspended, or revoked? If yes, explain: 20a. Have you ever used, or experimented with any illegal drug? If yes, explain: b. Have you ever sold, delivered, manufactured, smuggled, trafficked in illegal substances or drug paraphernalia? c. Have you ever possessed illegal substances or drug paraphernalia? 21a. Have you ever been convicted of a felony or a misdemeanor? b. Have you ever pled Nolo Contendere or pled guilty to a which is a felony or a misdemeanor? c. Have you ever had the adjudication of guilt withheld for a crime which is a felony or a misdemeanor (including sealed records)? d. If you answered "Yes" to 21 a, b, or c, complete the following: Date Place Agency Charge Disposition Details Are you or have you ever knowingly been under investigation by any local, state, federal agency, or entity for any wrongdoing either administrative, civil or criminal? If yes, explain: Have you ever committed a crime, whether arrested or not, that would constitute a felony or a misdemeanor? Yes No Have you ever been civilly or administratively adjudicated guilty to have engaged in any sexual abuse or sexual harassment? Have you now or have you ever had any affiliation with a known threat group “gang”? If so, describe the circumstances in detail.
DC2-873.docx