Volunteer Name: __________________________________________First Middle LastDate of Birth: __________________________________________ 5430PVOLUNTEER DISCLOSURE STATEMENTPURSUANT TO CHAPTER 43.43 RCWPlease Answer YES or NO to each listed item.
3.
Have you ever been convicted of any crime related to drugs as defined in RCW 43.43.830 and listed as follows:
manufacture, delivery, or possession with intent to deliver a controlled substance? Answer_____IF YES, PLEASE EXPLAIN BELOW.
In consideration of the District's review of this statement, I release the District and ...
Allowed
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