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<br />Jon.28, 2002 IO:46AM <br /> <br />No 6621 P 4/8 <br /> <br />10. List all convictions for any felony, crime, or OIdinancc: violation (exclude any <br />traffic ordinance violations). (Attach additional pages if necessary) <br /> <br />OFFENSE <br /> <br />DATE <br /> <br />LOCATION <br /> <br />DISPOSITION <br /> <br />11. Applicant's physical description: <br /> <br />Sex <br /> <br />Hair CalOI <br /> <br />Eye ColOI <br /> <br />Height <br /> <br />Weight <br /> <br />Complexion <br /> <br />12. List all training far providing the type of serVices for which this license is <br />requested. Attach copies of all appropriate certificates, etc. (Attach additional <br />pages if necessary) <br /> <br />a. <br /> <br />b. <br /> <br />c. <br /> <br />d. <br /> <br />e. <br /> <br />. <br /> <br />c. <br /> <br />List any other communities in which you are or have been shmlarly licensed. <br /> <br />a. <br /> <br />b. <br /> <br />c. <br /> <br />d. <br />