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In the past five years, have you been convicted of a felony?

Are you a U.S. citizen, or do you have a permit which allows you to work?

Have you ever been terminated or asked to resign from any job?

How many days of work have you missed in the last three years due to reasons other than paid holidays and vacation?

Do you have adequate transportation to and from work?

I certify that the facts contained in this application are true and correct