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Are you capable of performing the essential functions of the position for which you are applying? Yes No If “no, ” please explain: ______________________________________________________________________________________ Is there anything which would interfere with your attending work regularly? Yes No If “yes, ” please explain: ______________________________________________________________________________________ Are you legally eligible for employment in the U.S.? Yes No (Proof of U.S. immigration status will be required upon employment). Have you been convicted of a felony or misdemeanor? Yes No If “yes, ” when and where did it occur? __________________________________________________________________________ What was the nature and disposition of the offense? ______________________________________________________________ (Such conviction may be relevant if job-related, but does not necessarily disqualify you from employment.) Note: The following websites contain crime statistics for reported on-campus crimes and information regarding campus safet