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Location ARC CRC FLC SCC Please print your name clearly, as it appears on your social security card. Applicant Name: Last Name, First Name, Middle Initial Employee ID or Social Security #: The following information must be completed to be considered for employment: Have you ever been convicted of an offense other than a minor traffic violation (you must disclose convictions that have been dismissed pursuant to Penal Code Section 1203.4; Ed. Code 87008)? Yes No If yes, complete rever.
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