Solanocourts Form – Fill Out and Use This PDF

STATEMENT OF QUALIFICATIONS FOR SERVICE ON THE GRAND JURY

The purpose of this questionnaire is to provide the Judges of the Superior Court a list of persons qualified to serve on the Solano County Grand Jury. By completing this questionnaire, you become an applicant to serve on the jury. The information you provide here will remain confidential.

PLEASE PRINT OR TYPE

Name ______________________________________________________________________________

LastFirstMiddle Maiden

Address _____________________________________________________________________________

City and Zip Code _____________________________________________________________________

QUALIFICATIONS:	YES	NO
I am a citizen of the United States.	____	____
I am 18 years of age or older.	____	____
I have been a resident of Solano County for at least one year
prior to the date of this affidavit.	____	____
I am in possession of my natural faculties; I am of at least ordinary intelligence
and of sound judgment and fair character.	____	____
Are you presently serving as a trial juror in any court of this state?	____	____
Have you previously served on a Grand Jury? If so, indicate where and when.	____	____

__________________________________________________________________________________

Have you been discharged as a Grand Juror in any court of this state within
one year prior to the date of this affidavit?	____	____

	YES	NO
Have you been convicted of malfeasance in office, or any felony or other
high crime?	____	____
Have you ever been arrested and booked on any charge? If yes, please explain	____	____

__________________________________________________________________________________

__________________________________________________________________________________

Do you have any lawsuits and/or bankruptcy proceedings pending in the courts?	____	____
Are you now serving as an elected public official?	____	____
I possess a sufficient knowledge of the English language.	____	____

Note: All applicants for nomination as a member of the Solano County Grand Jury are subject to a background investigation by the appropriate law enforcement agency relative to the statutory qualifications for service and any other information that may bear on the prospective applicant’s ability and suitability as a Grand Juror.

Executed under penalty of perjury this _____day of _______________________, _______, at

(month) (year)

_______________________________, California.

_______________________________________

Signature

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This application is designed to assist the Presiding Judge of the Solano County Superior Court in establishing a list of qualified nominees for the Grand Jury, which represents a cross-section of the community. Completion and submission of this application will constitute your consent to be nominated as a prospective member of the Solano County Civil Grand Jury. All applicants will be notified by mail of the Grand Jury Orientation subsequent to their application submission. The information you provide will remain confidential.

		GRAND JURY APPLICATION
1.	_______________________________________________________________
	Last Name	First Name	Middle Name
2.	_______________________________________________________________
	Street Address	City	Zip Code

3.Home Phone Number_____________________________________________

4.Cell Phone Number_______________________________________________

5.Fax number_____________________________________________________

6.Email Address___________________________________________________

7.California Drivers License #________________________________________

8.Birth Date ____________________ Age: ___________

9.Social Security Number__________________

10. Birth Place________________ Years of Residence in Solano County?_____

11.Do you have any relatives employed by the County of Solano or any other public agency in Solano County? ________ If yes, please list their names and agencies:

____________________________________________________________________________

____________________________________________________________________________

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12.Are you a member of any civic, community, or charitable organizations? ____ If yes, please list the organizations, including positions held and dates.

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

13.Please attach your resume showing your employment for the previous ten years. Please include employment dates, employer name, employer phone number, employer contact person, and positions held. Explain any gaps in employment history, such as retirement or educational pursuits.

14.Name of Spouse/Partner___________________________________________

15.Spouse/Partner’s Occupation_______________________________________

16.Spouse/Partner’s Employer_________________________________________

EDUCATION

17. Please circle the highest grade completed in school:

High School	College	Post Graduate
9 10 11 12	13 14 15 16	17 18 19 20

18.Please list, if applicable, any degrees held and colleges and universities attended.

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

HEALTH

19.Do you have any physical condition that will interfere with your ability to perform the tasks of a Grand Juror, if you are selected? If yes, please explain.

_________________________________________________________________________

_________________________________________________________________________

GRAND JURY SERVICE

20.Applicants selected to the Grand Jury can expect to contribute 20 to 25 hours a week in conducting Grand Jury business, although the time required can vary depending upon incoming investigations. If you are selected and are currently employed will your employer allow you the necessary time off?

____________________________________________________________________________

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21.If selected to serve as a Civil Grand Juror, will you be able to serve for the entire year?

___________________________________________________________________________

22.If selected to serve as a Civil Grand Juror, will you, without reservation or qualification, support and uphold the Constitution and all laws of the United States and the State of California? _______________________________________________________________

23.If selected to serve on the Grand Jury, do you have any obligations or plans that would keep you away from Grand Jury service for more than two consecutive weeks during the calendar year. If yes, please explain.

_________________________________________________________________________

____________________________________________________________________________

24.The selection and swearing in of the Solano County Grand Jury will take place during the last week of June and your attendance in mandatory. Do you foresee a problem with this requirement? If yes, please explain.______________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

25.Please briefly explain why you want to serve on the Civil Grand Jury and why you believe you are qualified to serve. If necessary, please attach an additional sheet. (OPTIONAL

QUESTION)______________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

26.By what means did you learn of the Grand Jury recruitment? By newspaper, website, jury services, nominated, etc.

______________________________________________________________________________

You may return your Completed Applications to:

Grand Jury Office

Superior Court of California

Solano County

600 Union Avenue

Fairfield, CA. 94533

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DEMOGRAPHIC QUESTIONNAIRE FOR CIVIL GRAND JURY APPLICANTS

The Superior Court of California, County of Solano, is asking that all Civil Grand Jury applicants complete this form in order to comply with California Rule of Court 10.625. This rule intends to facilitate the courts’ continued efforts to achieve the goals stated in 10.50 of the Standards of Judicial Administration, which encourages courts to employ various methods of soliciting prospective candidates to serve on regular grand juries that reflect a representative cross section of the community they serve. This rule is also intended to assist the courts in establishing a formal mechanism whereby they can monitor the extent to which they achieve the goal of seating representative regular grand juries. This information will be detached from your application and will be used for statistical purposes only. This information will have no effect upon your application.

Check one only:	Check one only:	Check all that apply:
Age	Gender	Race/Ethnicity
18-25	Male	American Indian or Alaska Native
26-34	Female	Asian
35-44		Black or African American
45-54		Hispanic/Latino
55-64		Native Hawaiian or other Pacific Islander
65-74		White
75 and over		Other race or ethnicity
		Please state: ________________
		Decline to answer

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