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SUPERIOR COURT OF CALIFORNIA, COUNTY OF NAPA
Office of the Jury Commissioner
825 Brown Street
Napa, CA 94559
(707) 299-1110
GRAND JURY QUESTIONNAIRE
(Please print or type)
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Name: |
First:
Middle:
Last:
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Sex: M F |
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Address: |
Street
City
State
Zip
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Contact Information: |
Home Phone:
Work Phone:
Cell Phone:
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Email |
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Date of Birth: |
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Driver License: |
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LEGAL QUALIFICATIONS |
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Yes No |
I am a US Citizen and at least 18 years old. |
Yes No |
I am presently serving on a trial jury. |
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Yes No |
I will have been a resident of Napa County for at least 1
year by July 1, 2008.
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Yes No |
I have been discharged as a grand juror within the past
year. |
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Yes No |
I am in possession of my natural faculties, of ordinary
intelligence, of sound judgment, and fair character. |
Yes No |
I have been convicted of malfeasance in office or a felony. |
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Yes No |
I understand the spoken and written English language. |
Yes No |
I am serving as an elected public officer. |
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Please summarize your educational history: |
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Please summarize your employment history: |
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Please summarize your community service history: |
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Have you held public office or been employed by a public
agency? |
Yes No |
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(If "yes", please list all positions held) |
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Have you ever sued a public agency? |
Yes No |
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(If "yes", please describe details) |
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Do you have plans to be absent
from Napa County for longer than four continuous weeks between July
1, 2008, and June 30, 2009?
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Yes No |
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(If "yes", please give details) |
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Do you have transportation to attend meetings of the grand
jury? |
Yes No |
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Is there any reason you feel you are not capable of serving
on the grand jury? |
Yes No |
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(If "yes", please give details) |
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Are you interested in being appointed foreperson of the
grand jury? |
Yes No |
| How did you hear about the grand
jury? |
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I declare under penalty of perjury under the laws of the
State of California that the foregoing is true and correct.
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Date:
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Signature: _______________________
(To fax or mail please
print this page and sign your name here.) |
Demographic Study Required by California Rules of Court, Rule 10.625
(This information is collected for statistical purposes, and not considered in the selection process)
Race or Ethnicity (candidates may select more than one category)
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American Indian or Alaska Native
Asian
Black or African American
Hispanic/Latino
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Native Hawaiian or Other Pacific Islander
White
Other Race or Ethnicity
(please state):
Decline to answer
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