Please list all licenses and certifications (driver’s, CDL, teaching, nursing, CPA, vocational, etc.) that you possess.
Please list license information in this format: Professional license/certification / Registration number / State or licensing authority / Expiration date
Have you ever pleaded guilty to, or been convicted by a judge or jury of, a felony in this state or in any other state, or do you have any pending felony charge(s)? You must report any felony, even if probation, parole, an Alford Plea or pretrial diversion occurred?
If you answered "Yes" to the above question, please provide the details of each conviction or pending felony charge below, including DATE (month/year), LOCATION (city, county, state), and NATURE of ALL felony convictions or pending felony charges. Failure to list ALL felony convictions or pending felony charges may be considered a falsification of this application and result in: the withdrawal of an offer of employment, restriction on applying for any other positions at the University, and/or termination from any current employment with the University of Kentucky. It is not acceptable to substitute "will discuss in interview" for this information (please use a separate sheet if more than four):
In signing this document, I hereby certify that I have read the above information, that I understand the above information, and that I agree to abide by the above information.