Criminal History Record Consent

Criminal History Record Consent

Pursuant to Section 22.0835 of the Texas Education Code, CFISD is required to conduct a criminal history review.

CRIMINAL HISTORY RECORD CONSENT
IN COMPLIANCE WITH THE FCRA (Fair Credit Reporting Act)

Department: 193

Social Security Number*

Name*

First Name

Initial

Last Name

Sex*

Male Female

Race*

American Indian / Alaskan Asian/Pacific Islander Black Hispanic White

Date of Birth*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

E-mail Address*

Texas Driver License Number:*

Except for minor traffic violations such as parking or speeding, have you ever been convicted, fined, placed on probation, given a suspended sentence, given deferred adjudication, or forfeited bail in connection with any violation of law (misdemeanor or felony), regardless of any subsequent court dismissal, sealing or expungement?*

No Yes

(Conviction of a crime is not an automatic bar to volunteer. The district will consider the nature and date of the offense, and the relationship between the offense and the position for which you are applying.)

If YES, please provide details below.

Moral turpitude is an act of baseness, vileness, or depravity in the private or social duties which a person owes another member of society, or society in general, and which is contrary to the accepted rule of right and duty between persons, including but not limited to, theft, attempted theft, murder, rape, swindling, and indecency with a minor.

Have you ever been convicted of a felony or an offense involving moral turpitude?*

No Yes

If YES, please provide details below.

Have you ever been convicted of a felony or an offense involving moral turpitude and received probation or deferred adjudication?*

No Yes

If YES, please provide details below.

CONSENT CONFIRMATION

I am an applicant to be a global volunteer/mentor with the Cypress-Fairbanks Independent School District and have been advised that, as part of the application process, the district will conduct a criminal history check. The District has informed me that I have the right to review and challenge any negative information reported, within a reasonable time frame established at the sole discretion of the District. In compliance with the Fair Credit Reporting Act, I have been advised that upon request, I will be provided the name, address and telephone number of the reporting agency as well as the nature, substance, and source of all information.

I herby certify that all information provided is true, correct, and complete. I understand that if any information is found to be incorrect or incomplete, the District has the right to remove me from all volunteer responsibilities.

Signature*