Midway District Volunteer Application

Chapter 22 of the Texas Education Code requires school districts to review information on the criminal history of volunteers, and anyone performing services on school property where students are regularly present. The District considers “volunteers” to include any person who will be working with students, including, but not limited to camp counselors, mentors, tutors, field trip sponsors, overnight trip sponsors, and any non-employee who will have access to student information.

As an applicant to be a volunteer, I hereby am informed and understand that the District shall obtain criminal history record information on me and consent to the District doing so. I understand that this criminal history record search may include local, state and national law enforcement agency records and may include the use of third party vendors to acquire the criminal history. Information acquired by a third party vendor may include consumer reports which are subject to the provisions of the Fair Credit Reporting Act (FCRA).

I confirm that I have been informed that under the FCRA I may review and confirm any negative criminal history data that has been deemed to adversely impact my ability to volunteer. If there is a need for further clarification of my identity, I agree to provide additional information. The information provided on this application will be used solely for the purpose of obtaining criminal history record information. This application and all attachments become the property of the District. The District reserves the right to accept or reject any application.

Personal Information

Legal First Name

Address Line 1

Legal Middle Name

I don't have a middle name

Address Line 2 / Apt # / Building #

Legal Last Name

City

Maiden Name

State/Province/Region

Gender

Postal/Zip Code

Date Of Birth

Phone Number Phone number is required

Affiliation

Please note: An email will be sent to the email address entered to inform you of the status of your application. If you do not have access to email, please enter brandy.vowels@midwayisd.org and a district administrator will call you regarding the status.

Please select the schools at which you wish to volunteer

Please select the functions from the list below. (select all that apply)

Please select the organization(s) on behalf of which you are volunteering (if not applicable, select "None")

Please read the disclaimer below and provide your signature

By providing your signature, you are agreeing to abide by the rules and regulations of the District Volunteer Program. One or more of the volunteer activities you have selected may require you to provide your United States social security number so we can perform a criminal background check. Your social security number will only be used for this purpose and we do not retain this information.

Name

Signature

By signing your name you agree to all the above statements. Use the mouse or touch screen to sign.

Thank You

Your volunteer application has been successfully submitted and will be reviewed per the district’s volunteer policy. In the near future, you will be notified as to your volunteer status.

Thank you,

Human Resources Department

Midway ISD