LEGAL
1.Have you ever been arrested? IF NO SKIP TO NEXT SECTION………………………………………….
2.In the past month?...............................................................................................................
3.If yes, how many times? ____________________________________________________
4.In the past year?...................................................................................................................
5.If yes, how many times? ____________________________________________________
6.If yes, what were you arrested for? ___________________________________________
7.What was the name of your attorney? ________________________________________
8.Were you ever sentenced for a crime?…………………………………………………………………………….
9.If yes, number of prison sentences served? ____________________________________
10.What year(s) did this occur? _______________________________________________
11.Are you currently or have you ever been on probation or parole?....................................
12.If yes, what is the name of your attorney or probation officer? ____________________
WORK
1.What is your work history like? □Good □Poor □Sporadic □Other
2.How long do you normally keep a job? □Weeks □Months □Years
3.Are you retired?....................................................................................................................
4.If yes, what kind of work do you do/did you do in the past? _______________________
5.Have you ever served in the military?..................................................................................
6.If yes, are you: □Active □Retired □Other