Jury Questionnaire

This questionnaire has been prepared in order to save time in the selection of a jury. Please complete truthfully. Thank you.

IMPORTANT:

  • Enter your information and click Submit.
  • When prompted to REVIEW your information, make needed changes or click Submit, again.
  • Your information WILL NOT be sent until you REVIEW and click Submit the second time.

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Birth Date *
Order
Starting with High School, list the names of schools and colleges that you attended, one per line. For each school, state whether or not you graduated. Click the "Add another item" button to add additional schools.
Enter the occupation and the place of employment.
Order
List the age and occupation of each child, one per line. Click "Add another item" button to add additional children.
e.g. social, fraternal, recreational, athletic, or civic groups.
Order
List all groups that you belong to, one per line. Click the "Add another item" button to add additional groups.
Order
List all of your leisure activities (e.g. watch television, read, play sports, etc.), one per line. Click the "Add another item" button to add additional activities.
Do you have any health issues (e.g. sight, hearing, or emotional impairment, etc.) which may affect your ability to serve as a juror at this time?
PLEASE NOTE: Answering "Yes" to this question DOES NOT excuse you from jury service. Please refer to your Summons for instructions, if you believe you cannot serve as a juror.
Order
List all health issues that apply, one per line. Click the "Add another item" button to add additional health issues.
Have you, members of your family, or close friends been victims of a crime?
Order
List victim relation (e.g. self, brother, cousin, best friend, etc.), one per line. Include description of crime and when it occurred. Click the "Add another item" button to add additional victims.
Have you, members of your family, or close friends been involved in a lawsuit?
Order
List the lawsuits, one per line. Include the party involved, type of case (civil or criminal), and explain your or their involvement. Click the "Add another item" button to add additional lawsuits.
Have you, members of your family, or close friends been employed in the fields of law enforcement or security, including federal, state, county, city, military, auxiliary, or volunteer experience?
Order
List positions, one per line. Include who and when. Click the "Add another item" button to add additional positions.
Do you read newspapers?
Order
List the newspapers that you read, one per line. Click the "Add another item" button to add additional newspapers.
Have you ever been convicted of a crime, other than a minor traffic offense?
Order
List your criminal convictions, one per line. Click the "Add another item" button to add additional convictions.
Have any family members ever been convicted of crimes, other than minor traffic offenses?
Order
List their criminal convictions, one per line. Click the "Add another item" button to add additional convictions.
By checking this box, I swear or affirm that the foregoing answers are true, to the best of my knowledge.