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Volunteer
Criminial History Authorization for Volunteers and Contract Providers

In connection with my application and desire to engage in volunteer activities, I have been advised and I hereby consent and authorize Comal ISD and its agent, at any time during or subsequent to my application process, to conduct a background check that may include a criminal record check and such additional verifications and reference checks as deemed necessary.  I do hereby consent to Comal ISD’s use of any information provided on this form or during the application process in performing the non-employment related background check.  I agree to release, indemnify and hold harmless Comal ISD and any agency used by Comal ISD with regard to any information provided by the agency.  I have been informed that I will have a reasonable opportunity to clear up any mistaken information provided by the agency within a reasonable time frame established within the sole discretion of Comal ISD.  I acknowledge that facsimile, copy or electronic version of this form shall be as valid as the original. 


The following are my responses to questions about my criminal history (if any).
Volunteer Type:
Please make a selection.
Last Name:
A value is required.
First Name (Per Birth Certificate):
A value is required.
Middle (Per Birth Certificate):
Name(s) used if different from current name
Ex: Maiden Name
Address:
A value is required.
Apartment #:
City:
A value is required.
County:
A value is required.
State:
A value is required.
Zip:
A value is required.
Email:
A value is required.Invalid format.
   
Please note that the format of the date of birth has changed.  The new format is YYYYMMDD.  Entering this date in a different format may delay the approval process
Date of Birth:
A value is required.Minimum number of characters not met.Exceeded maximum number of characters. YYYYMMDD
Social Security Number:
A value is required.Invalid format.
EX: xxx-xx-xxxx
Sex:
Please make a selection.
School(s) where you want to volunteer:
YOU MUST MAKE A SELECTION. PLEASE SELECT "NONE" IF YOU DO NOT WANT TO SELECT A SCHOOL. 
Elementary

Middle School

High School


1.  Yes No Have you ever been convicted or plead guilty before a court for any federal, state or municipal criminal offense? (exclude minor traffic misdemeanors).
If yes, please provide details below.
State:
A value is required.
County:
A value is required.
Date of Offense:
Invalid format. EX:  mm/dd/yyyy
Details of conviction:
A value is required.
   
2. Yes No Have you ever received deferred adjudication or similar disposition for any federal, state or municipal offense?
If yes, please provide details below.
State:
A value is required.
County:
A value is required.
Date of Offense:
Invalid format.A value is required.Invalid format.EX:  mm/dd/yyyy
 
Details of Offense:
A value is required.
   
3.  Yes No Have you ever received probation or community supervision for any federal, state or municipal offense?  
If yes, please provide details below.
State:
A value is required.
County:
A value is required.
Date of Offense:
Invalid format.A value is required.Invalid format.EX:  mm/dd/yyyy
 
Details of Supervision:
A value is required.
   
4.  Yes No Have you ever been convicted of any criminal offense in a country outside the jurisdiction of the United States? 
If yes, please provide details below.
Country:
A value is required.
City:
A value is required.
Date of Offense:
Invalid format.A value is required.Invalid format.EX:  mm/dd/yyyy
 
Details of Conviction:
A value is required.
   
5.  Yes No   As of the date of this consent form, do you have any pending charges against you?
If yes, please provide details below.
 
State:
A value is required.
County:
A value is required.
Date of Arrest:
Invalid format.A value is required.Invalid format.  EX:  mm/dd/yyyy
Details of Pending Charges:
A value is required.

This section is to be used to list the last three counties and states of residence.

         
City/Town County State    
A value is required. A value is required. A value is required.    
   
   
Date:
A value is required.
       

DPS Computerized Criminal History (CCH) Verification Form

I acknowledge that a Computerized Criminal History (CCH) will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on Name and DOB identifiers I supply.  (This is not a consent form.) Authority for this agency to access an individual's criminal history data may be found in Texas Government Code 411; Subchapter F.

Name-based information is not an exact search and only fingerprint record searches represent true identification to criminal history, therefore the organization conducting the criminal history check is not allowed to discuss with me any criminal history record information obtained using this method.  The agency may request that I have a fingerprint search performed to clear any misidentification based on the result of the name and DOB search.  Once this process is completed the information on my fingerprint criminal history record may be discussed with me.

In order to complete the process I must make an appointment with the Fingerprint Applicant Services of Texas (FAST) as instructed online at www.txdps.state.tx.us/Crime Records/Review of Personal Criminal History or by calling the DPS Program Vendor at 1-888-467-2080, fingerprinting services company.

(This copy must remain on file by your agency.  Required for future DPS Audits)
Comal Independent School District
Agency Name
Sonya Vargas
Agency Representative Name
FOR DISTRICT USE:
Please:
Check and Initial each Applicable Space
CCH Report Printed:
Yes
No 
SV
initial
Purpose of CCH: Employment
Empl   
Vol/Contractor
SV
initial
Date Printed:
initial
Destroyed Date:
initial
I agree that I have read and understand the above information.  Please Enter Initials
A value is required.
Please enter the date of acknowlegement:
All volunteers of the Comal Independent School District can be volunteers without regard to national origin, race, sex, or creed.  Information generated from this form is handled in a confidential manner


 
 
©2005 Comal Independent School District