NAME(Required)
Address
MM slash DD slash YYYY
Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the equivalent) forward, related to behavioral misconduct that resulted in your long-term suspension (more than 10 days)?
Excluding traffic infractions, have you ever been found guilty or convicted of a misdemeanor, felony, or other crime (including special or general court martial)? [Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.]
Do you have any criminal charges pending against you?
Excluding traffic violations, have you ever entered a plea of no contest or nolo contendere, or an Alford plea, to a misdemeanor, felony, or other criminal charge; or received a deferred prosecution or prayer for judgment continued for such a charge; or otherwise accepted responsibility for such a crime?
Are you currently, or have you ever been, trespassed/banned from Livingstone College property?
Do you have any pending disciplinary or behavioral issues with a prior institution that have yet to be resolved, or did you withdraw from a prior institution while under investigation for disciplinary or behavioral issues?
Acknowledgement Statement