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Best times to be reached
Best time to be reached
If yes, when and where?
If an accommodation is needed, how would you perform the job duties, and with what accommodation(s)
If yes please provide License # Type and State
if yes please indicate type of offense and dates
If yes give complete details:(Date, Place, Charges, Disposition
Yes or No
please select GED/USAFI
yes or No
Yes or No and if Yes, Why
from - To
a) Denial of Employment;
b) Disciplinary Action to include termination of employment.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
Yes, No or Not Applicable
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