Annual Criminal History Record Information

CONFIDENTIAL

The Wimberley Independent School District is required by state law to obtain criminal history record information on all applicants/volunteers prior to employment and/or volunteering with the District (Texas Education Code §22.083).  The information requested below is necessary to obtain criminal history record information. If you wish to fill out a paper copy of this form, please visit www.wimberleyisd.net/volunteer.

Sign in to Google to save your progress. Learn more
Which program are you a volunteer for? *
Required
What is your legal last name? (As it appears on your driver's license.) *
What is your legal first name?  (As it appears on your driver's license.) *
What is your legal middle name?  (As it appears on your driver's license.) *
What is your social security number?
(Utilized should more than one name appear.)
 *
What is your date of birth?
(Please use MM/DD/YYYY format.)
 *
What is your sex? *
What is your ethnicity? *
If volunteering, indicate the campus you are requesting access to: (Please check all that apply.) *
Required
Signature Required
I understand the information I am providing about age, sex, and ethnicity will not be used to determine eligibility for employment, but will be used solely for the purpose of obtaining criminal history record information.
Electronic Signature Acknowledgement: By typing your full name (first and last) in the space below, you are signing this document electronically. You agree that your electronic signature has the same legal validity and effect as your handwritten signature on the document, and that it has the same meaning as your handwritten signature. *
Signature Date *
MM
/
DD
/
YYYY
What is your email address? *
What is your phone number? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wimberley Independent School District. Report Abuse
Google Forms