Deputy Application

Maries County Sheriff's Office
211 4th Street ~ P.O. Box 23, Vienna, Missouri 65582
Office: 573-422-3381 Fax: 573-422-3100

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[{"type":"header","subtype":"h2","label":"Certificate of Application and Authorization for Release of Information","className":"d-block"},{"type":"header","subtype":"h3","label":"Applicant Personal History Questionnaire","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div>I                       (Print full name), hereby certify that all statements made on or in connection with this application are true and complete to the best of my knowledge.  I understand and agree that any misstatements or omissions of material facts will cause forfeiture on my part of all </div><div>rights to initial employment or continued employment by the Maries County Sheriff's Office.</div><div><br></div><div>The intent of this authorization is to make available a full and complete disclosure of any and all information pertaining to my person; therefore, I do hereby authorize all present or past employers, all law enforcement agencies, all military agencies, the Veterans Administration, the U.S. Army, U.S. Air Force, U.S. Coast Guard, all Federal, State or local government agencies, State and Federal tax bureaus, credit bureaus, schools, insurance companies and universities to furnish the Supervisor of the Personnel Services Unit of the Maries County Sheriff's Office with any and all available information regarding my past or present performance, conduct or behavior. I further authorize the release of any punitive or disciplinary action, or memorandum, to the Supervisor in order that the information be evaluated to assist in the determination of my suitability for police work.</div><div><br></div><div>I understand the Maries County Sheriff's Office acquisition, retention, and sharing of information related to my employment application is generally authorized under state and federal citations. The purpose for the Department requesting this information is to </div><div>conduct a complete background investigation pertaining to my fitness to serve as Maries County Law Enforcement. This background investigation may include inquiries pertaining to my employment, education, medical history, credit history, criminal history, and any information relevant to my character and reputation. By signing this form, I am acknowledging that I have received notice and have provided consent for the Maries County Sheriff's Office to use this information to conduct such a background investigation, which may include the searching of N-DEx, criminal justice databases, private databases, and public databases.</div><div><br></div><div>I reiterate and emphasize that the intent of this authorization is to provide full and free access to the background and history of my personal and business life for the specific purpose of conducting a pre-employment background investigation.</div><div><br></div><div>I authorize the Maries County Sheriff's Office to make an inquiry and gather any documents of my present and past employers regarding my character, integrity, reputation and performance.</div><div><br></div><div>I authorize the release of any and all of the afore-listed information regarding my person, employment, credit or any other aspect, whether personal or otherwise, that may or may not be in their written records.</div><div><br></div><div>I understand that all materials pertaining to this background investigation become the property of the Maries County Sheriff's Office and will not be made available or returned to me.</div><div><br></div><div>I agree to indemnify and hold harmless the person to whom this request is presented, along with the company or organization therein from any and all claims, damages, losses and expenses, including reasonable attorney’s fees arising out of complying with this request.</div><div><br></div><div>I understand that in the event my application is disapproved, the sources of information obtained are confidential and cannot be revealed to me.</div><div><br></div><div>A copy of this authorization will be considered as effective and valid as the original, even though the copy does not contain an original writing of my signature.</div><div><br></div>","className":"d-block"},{"type":"checkbox-group","required":true,"label":"Acknowledgement of Release of Information","name":"Acknowledgement-of-Release-of-Information","className":"d-block","values":[{"label":"Acknowledge","value":"Acknowledge"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Applicant Personal History Questionnaire","className":"d-block"},{"type":"header","subtype":"h3","label":"Pre-Employment History File Access Restricted by General Orders","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div>The information requested on this questionnaire will be used for reference by those who will be considering your application for employment or training with the St. Louis County Police Department. An extensive background investigation will be conducted into your personal history. Applicants for the position of police officer will be required to take a polygraph (lie detector) examination to confirm the information in this questionnaire, and to determine other items of background information.</div><div><br></div><div>ANY FALSE, MISLEADING, OR INCOMPLETE INFORMATION SUBSTITUTED FOR ACCURATE INFORMATION WILL BE GROUNDS TO DISQUALIFY YOU FROM FURTHER CONSIDERATION IN THE APPLICATION PROCESS WITH THE MARIES COUNTY SHERIFF'S OFFICE.</div>","className":"d-block"},{"type":"checkbox-group","required":true,"label":"<div>I confirm that I have read and that I understand the above and that all statements and documents presented to the Maries County Sheriff's Office are true, correct, complete and made in good faith.</div>","name":"I-confirm-that-I-have-read-and-that-I-understand-the-above-and-that-all-statements-and-documents-presented-to-the-Maries-County-Sheriffs-Office-are-true-correct-complete-and-made-in-good-faith","className":"d-block","values":[{"label":"Acknowledge","value":"Acknowledge"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"Directions","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div>1. BEFORE YOU BEGIN, read the entire set of directions and listing of documents required for submission.  An application checklist is provided on page 13 for your convenience. This is a competitive process, therefore, applications will not be accepted, processed or evaluated unless complete. All addresses and phone numbers must include zip codes and area codes.</div><div><br></div><div>2. Be certain that each question is answered COMPLETELY and CORRECTLY. Submit all documents as requested. If a question does not apply to you, write \"N/A\" (not applicable) in the space. Leave no blank space.</div><div><br></div><div>3.  Additional space is provided on pages 11 and 12 for answers which require clarification or further explanation. All entries on pages 11 and 12 will begin with page, section number (Roman numerals I-XIII), and question (letters A-L) you are explaining or clarifying.</div><div><br></div><div>4. Pursuant to Public Law 93-579, the disclosure of your Social Security Number is completely voluntary. Your refusal to reveal it will in no way affect applications for any job or consideration provided by this Department. The Social Security Number assists the Department in differentiating between applicants with similar or identical names.</div><div><br></div><div>5. Upon completion, the questionnaire must be submitted and/or printed and returned to the Maries County Sheriff's Office.</div>","className":"d-block"},{"type":"header","subtype":"h2","label":"Personal Information","className":"d-block"},{"type":"text","required":true,"label":"Last Name","name":"Last-Name","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"First Name","name":"First-Name","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Middle Name","name":"Middle-Name","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Suffix","description":"Jr, II, III, IV...","name":"Suffix","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"text","required":true,"label":"House Number","placeholder":"123","name":"Street-Number","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Street","placeholder":"Elm St","name":"Street","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"City","placeholder":"Vienna","name":"City","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"State","placeholder":"MO","name":"State","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"Zip Code","placeholder":"65582","name":"Zip-Code","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"date","required":true,"label":"Date of Birth","name":"Date-of-Birth","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Social Security Number","placeholder":"000-00-0000","name":"Social-Security-Number","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Operator License Number","name":"Operator-License-Number","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"State Issued","name":"State-Issued","className":"col-md-6 col-lg-3","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC"},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO","selected":true},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"text","required":true,"label":"Height","description":"In Inches","name":"Height","maxlength":65,"className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Weight","placeholder":"200","name":"Weight","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Hair Color","name":"Hair-Color","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Eye Color","name":"Eye-Color","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"textarea","required":true,"label":"Place of Birth","placeholder":"Vienna, MO","name":"Place-of-Birth","subtype":"textarea","rows":1,"className":"col-md-6"},{"type":"text","label":"List any other Names you have ever used","name":"List-any-other-Names-you-have-ever-used","className":"col-md-6","subtype":"text"},{"type":"radio-group","required":true,"label":"Marital Status","inline":true,"name":"Marital-Status","className":"d-block","values":[{"label":"Single","value":"Single"},{"label":"Engaged","value":"Engaged"},{"label":"Married","value":"Married"},{"label":"Seperated","value":"Seperated"},{"label":"Divorced","value":"Divorced"},{"label":"Widowed","value":"Widowed"}]},{"type":"text","required":true,"label":"Spouse/Emergency Contact Name","name":"SpouseEmergency-Contact-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Spouse/Emergency Contact Address","name":"SpouseEmergency-Contact-Address","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Spouse/Emergency Contact Phone Number","name":"SpouseEmergency-Contact-Phone-Number","className":"col-lg-4","subtype":"text"},{"type":"radio-group","required":true,"label":"Are you a Citizen of the United States","name":"Are-you-a-Citizen-of-the-United-States","className":"col-md-6","values":[{"label":"Yes","value":"Yes","selected":true},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"radio-group","label":"Were you Naturalized","name":"Were-you-Naturalized","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div>LIST FIRST YOUR PRESENT ADDRESS, THEN LIST ALL ADDRESSES WHERE YOU HAVE LIVED FOR THE PAST TEN (10) YEARS, INCLUDING YOUR ADDRESS(ES) IN THE MILITARY SERVICE OR WHILE ATTENDING COLLEGE:</div>","className":"d-block"},{"type":"date","required":true,"label":"Current Address Start Date ","placeholder":"Current","name":"Current-Address-Date-Start","value":"Current","className":"col-md-6 col-lg-3"},{"type":"date","required":true,"label":"Current Address Date","description":"Today","name":"Current-Address-Date","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Current Address","placeholder":"123 Elm St. Vienna, MO 65582","name":"Current-Address","className":"col-md-6","subtype":"text"},{"type":"date","label":"Previous Address Start Date #2","name":"Previous-Address-Start-Date-2","value":"Current","className":"col-md-6 col-lg-3"},{"type":"date","label":"Previous Address End Date #2","name":"Previous-Address-End-Date-2","className":"col-md-6 col-lg-3"},{"type":"text","label":"Previous Address #2","name":"Previous-Address-2","className":"col-md-6","subtype":"text"},{"type":"date","label":"Previous Address Start Date #3","name":"Previous-Address-Start-Date-3","value":"Current","className":"col-md-6 col-lg-3"},{"type":"date","label":"Previous Address End Date #3","name":"Previous-Address-End-Date-3","className":"col-md-6 col-lg-3"},{"type":"text","label":"Previous Address #3","name":"Previous-Address-3","className":"col-md-6","subtype":"text"},{"type":"date","label":"Previous Address End Date #4","name":"Previous-Address-End-Date-4","className":"col-md-6 col-lg-3"},{"type":"date","label":"Previous Address Start Date #4","name":"Previous-Address-Start-Date-4","value":"Current","className":"col-md-6 col-lg-3"},{"type":"text","label":"Previous Address #4","name":"Previous-Address-4","className":"col-md-6","subtype":"text"},{"type":"date","label":"Previous Address End Date #5","name":"Previous-Address-End-Date-5","className":"col-md-6 col-lg-3"},{"type":"date","label":"Previous Address Start Date #5","name":"Previous-Address-Start-Date-5","value":"Current","className":"col-md-6 col-lg-3"},{"type":"text","label":"Previous Address #5","name":"Previous-Address-5","className":"col-md-6","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"radio-group","required":true,"label":"HAVE YOU EVER APPLIED FOR A POSITION WITH THIS DEPARTMENT BEFORE? (IF YES, DATE OF APPLICATION)","name":"HAVE-YOU-EVER-APPLIED-FOR-A-POSITION-WITH-THIS-DEPARTMENT-BEFORE","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","label":"Date of Previous Application","name":"Date-of-Previous-Application","maxlength":10,"className":"col-md-6","subtype":"text"},{"type":"radio-group","required":true,"label":"<div>ARE YOU ACQUAINTED WITH ANY MARIES COUNTY EMPLOYEES? IF \"YES,\" PLEASE LIST:</div>","name":"ARE-YOU-ACQUAINTED-WITH-ANY-MARIES-COUNTY-EMPLOYEES-IF-YES-PLEASE-LIST","className":"col-md-6","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"text","label":"List Names","name":"List-Names","maxlength":10,"className":"col-md-6","subtype":"text"},{"type":"header","subtype":"h2","label":"REFERENCES","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div>LIST THREE (3) CHARACTER REFERENCES, TWO OF WHICH ARE NEAR YOUR SAME AGE AND ARE NOT RELATIVES, IN-LAWS OR PAST EMPLOYERS WHO HAVE KNOWN YOU WELL DURING THE PAST THREE YEARS OR MORE:</div>","className":"d-block"},{"type":"text","required":true,"label":"Reference #1 Name","name":"Reference-1-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference #1 Phone Number","name":"Reference-1-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Reference #1 Years Acquainted","name":"Reference-1-Years-Acquainted","maxlength":2,"className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Reference #2 Name","name":"Reference-2-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference #2 Phone Number","name":"Reference-2-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Reference #2 Years Acquainted","name":"Reference-2-Years-Acquainted","maxlength":2,"className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Reference #3 Name","name":"Reference-3-Name","className":"col-md-6","subtype":"text"},{"type":"text","subtype":"tel","required":true,"label":"Reference #3 Phone Number","name":"Reference-3-Phone-Number","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Reference #3 Years Acquainted","name":"Reference-3-Years-Acquainted","maxlength":2,"className":"col-md-6 col-lg-3","subtype":"text"},{"type":"header","subtype":"h2","label":"ARREST HISTORY","className":"d-block"},{"type":"select","required":true,"label":"<div>OTHER THAN TRAFFIC CITATIONS, HAVE YOU, AS AN ADULT OR JUVENILE, BEEN ARRESTED, CONVICTED, CHARGED, QUESTIONED, ACCUSED OR DETAINED FOR ANY REASON BY ANY POLICE, SECURITY OFFICER OR MILITARY POLICE AUTHORITY, EITHER IN THE UNITED STATES OF AMERICA OR IN ANY FOREIGN COUNTRY? (IF \"YES,\" DESCRIBE BELOW AND EXPLAIN IN FULL DETAIL ON BOTTOM OF FORM).</div>","name":"OTHER-THAN-TRAFFIC-CITATIONS-HAVE-YOU-AS-AN-ADULT-OR-JUVENILE-BEEN-ARRESTED-CONVICTED-CHARGED-QUESTIONED-ACCUSED-OR-DETAINED-FOR-ANY-REASON-BY-ANY-POLICE-SECURITY-OFFICER-OR-MILITARY-POLICE-AUTHORITY-EITHER-IN-THE-UNITED-STATES-OF-AMERICA-OR-IN-ANY-FOREIGN-COUNTRY","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"date","label":"Date Field 1","name":"Date-Field-1","className":"col-md-6 col-lg-3"},{"type":"text","label":"Charge #1","name":"Charge-1","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Department/Agency #1","name":"DepartmentAgency-1","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Disposition #1","name":"Disposition-1","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"date","label":"Date Field 2","name":"Date-Field-2","className":"col-md-6 col-lg-3"},{"type":"text","label":"Charge #2","name":"Charge-2","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Department/Agency #2","name":"DepartmentAgency-2","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Disposition #2","name":"Disposition-2","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"date","label":"Date Field 3","name":"Date-Field-3","className":"col-md-6 col-lg-3"},{"type":"text","label":"Charge #3","name":"Charge-3","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Department/Agency #3","name":"DepartmentAgency-3","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Disposition #3","name":"Disposition-3","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"select","required":true,"label":"<div>WERE YOU EVER SERVED WITH A CRIMINAL OR CIVIL SUBPOENA OR SUMMONS OTHER THAN TRAFFIC? (IF \"YES,\" DESCRIBE BELOW AND EXPLAIN IN FULL DETAIL ON BOTTOM OF FORM)</div>","name":"WERE-YOU-EVER-SERVED-WITH-A-CRIMINAL-OR-CIVIL-SUBPOENA-OR-SUMMONS-OTHER-THAN-TRAFFIC","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No","selected":true}]},{"type":"select","required":true,"label":"<div>HAVE THE POLICE EVER BEEN CALLED TO ANY OF YOUR FORMER OR CURRENT RESIDENCES FOR ANY REASON?  (IF \"YES,\" DESCRIBE BELOW AND EXPLAIN IN FULL DETAIL ON BOTTOM OF FORM)</div>","name":"HAVE-THE-POLICE-EVER-BEEN-CALLED-TO-ANY-OF-YOUR-FORMER-OR-CURRENT-RESIDENCES-FOR-ANY-REASON","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"select","required":true,"label":"<div>HAVE YOU EVER BEEN INVOLVED IN ANY UNDETECTED CRIME, INCLUDING THE BUYING OR SELLING OF ILLICIT DRUGS?  (IF \"YES,\" DESCRIBE BELOW AND EXPLAIN IN FULL DETAIL ON BOTTOM OF FORM)</div>","name":"HAVE-YOU-EVER-BEEN-INVOLVED-IN-ANY-UNDETECTED-CRIME-INCLUDING-THE-BUYING-OR-SELLING-OF-ILLICIT-DRUGS","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"select","required":true,"label":"<div>ARE YOU NOW UNDER CHARGES FOR ANY VIOLATION OF LAW?  (IF \"YES,\" DESCRIBE BELOW AND EXPLAIN IN FULL DETAIL ON BOTTOM OF FORM)</div>","name":"ARE-YOU-NOW-UNDER-CHARGES-FOR-ANY-VIOLATION-OF-LAW","className":"d-block","values":[{"label":"Yes","value":"Yes"},{"label":"No","value":"No"}]},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"header","subtype":"h2","label":"EDUCATION AND SKILLS","className":"d-block"},{"type":"checkbox-group","required":true,"label":"DO YOU HAVE: (CHECK APPROPRIATE BOXES)","name":"DO-YOU-HAVE-CHECK-APPROPRIATE-BOXES","className":"d-block","values":[{"label":"GED/HIGH SCHOOL","value":"GED/HIGH SCHOOL"},{"label":"3-31 COLLEGE CREDIT HOURS","value":"3-31 COLLEGE CREDIT HOURS"},{"label":"32-63 COLLEGE CREDIT HOURS","value":"32-63 COLLEGE CREDIT HOURS"},{"label":"64-119 COLLEGE CREDITS","value":"64-119 COLLEGE CREDITS"},{"label":"BACHELOR'S DEGREE","value":"BACHELOR'S DEGREE"},{"label":"POST GRADUATE DEGREE","value":"POST GRADUATE DEGREE"}]},{"type":"header","subtype":"h4","label":"STARTING WITH THE MOST RECENT, LIST ALL ELEMENTARY, HIGH SCHOOL, COLLEGES AND UNIVERSITIES YOU HAVE ATTENDED:","className":"d-block"},{"type":"date","label":"Date Attended From","name":"Date-Attended-From","className":"col-md-6 col-lg-3"},{"type":"date","label":"Date Attended To","name":"Date-Attended-To","className":"col-md-6 col-lg-3"},{"type":"text","label":"Name of School","name":"Name-of-School","className":"col-md-6","subtype":"text"},{"type":"text","label":"Number of Credits Completed","name":"Number-of-Credits-Completed","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","label":"Type of Degree","name":"Type-of-Degree","className":"col-md-6 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