If you answered NO to the criminal question(s) on the previous page, or you are applying for positions located in Hawaii, Massachusetts, or Philadelphia please enter: NONE in the space provided below.
If you answered YES to the criminal question(s) on the previous page, to help us evaluate your application, please list the name of the state in which you are applying for a position, describe the nature of the crime(s), when it occurred and your subsequent rehabilitation. Please also include the City, State, Zip Code and County of the conviction and all specific conviction details.
PLEASE NOTE: A conviction will not necessarily be an automatic bar to employment.