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If I have been convicted of any offense I have listed it on a separate sheet of paper and attached it to this form. Additionally I authorize the SCP staff to conduct an Oregon Criminal Registry Check an FBI fingerprint check and a National Sex Offender Public Registry Check NSOPR and that my participation in the program is contingent on acceptable results from these checks. Name Street Address City/State Phone Please list below your projections of the sources and amounts of the income for you...
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