DHS Screening Questions

1

I have a high school diploma or GED* This field is required.

Yes

No

2

I have a valid driver's license* This field is required.

Yes

No

3

I will submit to a drug screen/test and pass it.* This field is required.

Yes

No

4

I will submit to and pass a criminal background check.* This field is required.

Yes

No

5

6

What is your full name?

7

What is the best number to reach you?* This field is required.

Please enter a valid phone number.

8

Please provide your email address.* This field is required.

example@example.com

9

Please provide your address.

10

What city do you live in?

11

What state do you live in?

15