Background Check Form - Broward County Public Schools Page 3

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A
C
R
I
DDITIONAL
RIMINAL
ECORD
NFORMATION
Name
Soc Sec No.
I
#2
NCIDENCE
If Arrested, Where?:
Date of Arrest:
Arresting Agency:
Date of Arrest:
Offense:
Final Disposition:
Please provide detailed explanation:
I
#3
NCIDENCE
If Arrested, Where?:
Date of Arrest:
Arresting Agency:
Date of Arrest:
Offense:
Final Disposition:
Please provide detailed explanation:
(Continued on next page)

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