91 GENERAL BACKGROUND INFORMATION You must give complete answers to all questions. If you answer “Yes” to any question, you must list all location of occurrence. Conviction of a criminal offense is not a bar to employment in all cases. Each case is considered on its merits. Your answers will be verified with appropriate police records. Criminal Offense includes felonies, misdemeanors, summary offenses and convictions resulting from a plea of”nolo contendere” (no contest). Conviction is an adjudication of guilt and includes determinations before a court, a district justice or a magistrate, which results in a fine, sentence or probation. You may omit: minor traffic violations, offenses committed before your 18th birthday which were adjudicated in juvenile court or under a Youth Offender Law, and any convictions which have been expunged by a court or for which you successfully completed an Accelerated Rehabilitative Disposition program. Were you ever convicted of a criminal offense? Are you currently under charges for a criminal offense? Have you ever forfeited bond or collateral in connection with a criminal offense? Within the last ten years, have you been fired from any job for any reason? Within the last ten years, have you quit a job after being notified that you would be fired? Have you ever been professionally disciplined in any state? Professional disciplined means the annulment, revocation or suspension of your teaching certification or having received a letter of reprimand from an agency, board or commission of state government, such as the Pennsylvania Professional Standards and Practices Commission. Are you subject to any visa or immigration status, which would prevent lawful employment? YES NO YES NO YES NO YES NO YES NO YES NO YES NO Note: If you answered “Yes” to any of the above questions, please provide a detailed explanation on a separate sheet of paper, including dates, and attach it to this application. Please print and sign your name on the sheet, and include your social security number.
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