I understand that the information requested below regarding date of birth is for the sole purpose of identification and the accurate gathering of the criminal history record information, and that it will not be used to discriminate against me in violation of the law. I understand that the provision of my Social Security number is required by law.
Please furnish name and phone number of three personal references. These individuals should not be previous employers or relatives.
Begin with your present or most recent job. Include military service assignments and internships.