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Placer County Human Resources Department

Supplemental Questionnaire

Last Name First Name


Administrative Legal Clerk - Entry

Sheriff's Office Corrections Division

Supplemental Questionnaire



Part I - Conviction History (Not Scored)


Have you been convicted of a crime?

Yes No


Conviction of a crime is not necessarily a bar to employment.  Each case is considered separately based on job requirements. 

You must disclose convictions, including reckless and drunk driving convictions, even if:

  • It happened a long time ago;
  • It was only a misdemeanor;
  • You didn’t have to go to court (your attorney went for you);
  • You had no jail time or the sentence was only a fine or probation.

You may OMIT:   

  • Minor traffic violations;
  • An arrest or detention that did not result in a conviction (Labor Code section 432.7);
  • An arrest, detention, processing, diversion, supervision, adjudication, or court disposition that occurred while you were subject to the process and jurisdiction of the juvenile court;
  • A conviction that has been judicially dismissed or ordered sealed, expunged, or statutorily eradicated pursuant to law (e.g. juvenile offense records sealed pursuant to Welfare and Institutions Code section 389 and Penal Code sections 851.7 or 1203.45);
  • A non-felony conviction for possession of marijuana that is two or more years old (Labor Code section 432.8).


If YES, please state:  1) date, 2) charge, 3) place, 4) court, and 5) action taken in the space below.

If NO, please enter N/A.


Part II - Additional Questions (Not Scored)

Please indicate your responses to the questions below by clicking either "yes" or "no". Your responses will serve as a screening tool only and will not be scored. 


Are you willing to work on an extra help/temporary basis?

Yes No

Are you willing to work shifts that are outside "normal" working hours (swing, graveyard, etc.)?

Yes No

Are you willing to work holidays?

Yes No

Are you willing to work weekends?

Yes No

Are you willing to work in a secured, locked-down facility in proximity to incarcerated adults?

Yes No

Are you willing to work in an environment where you regularly interface with members of the public who may be hostile or emotionally distressed?

Yes No

Are you willing to work in close contact with members of the public to obtain DNA samples and fingerprints?

Yes No

Are you willing to work in an environment where you will have close interaction with drug, gang, sex, and arson registrants?

Yes No

Are you willing to make yourself available on short notice to meet minimum staffing needs?

Yes No


 Thank you for completing the supplemental portion of the application process. We encourage applicants to review their responses for accuracy prior to submitting.

Please "Save & Continue" to move forward to the next tab in the application process.

Be sure to click the "Submit" button once the application and supplemental questionnaire have been completed. You will receive confirmation that the application has been submitted.