Pearsall ISD Volunteer Application & Background Check Form
Please complete this form if you would like to volunteer to work on a Pearsall ISD campus. The
Pearsall Independent School District is authorized by state law (TEC 22.083), DC(Legal) Policy
and GKG(Legal Policy to obtain Criminal History Record Information CHRI on all school
volunteers who sign a statement of consent allowing the District to obtain this information. The
campus principal or designee shall inform the volunteer when he or she may begin. The
information requested below is necessary to obtain criminal history record information.
Last Name (as it appears on your drivers license or ID card) *
Your answer
First Name (as it appears on your drivers license or ID card) *
Your answer
Middle Name (as it appears on your drivers license or ID card)
Your answer
Other Names Used (i.e. maiden name)
Your answer
Date of Birth (mm/dd/yyyy) *
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Social Security Number (xxx-xx-xxxx) *
Your answer
Drivers License or State ID Number *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Sex *
DPS Computerized Criminal History (CCH) Verification
I acknowledge that a Computerized Criminal History (CCH) check may be performed by accessing the Texas Department of Public Safety Secure Website and may be based on name and DOB identifiers. (This is not a consent form, but serves as information for the applicant.) 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 record information (CHRI), therefore the organization conducting the criminal history check is not allowed to discuss with my any CHRI obtained using the name and DOB method. The agency may request that I also have a fingerprint search performed to clear any misidentification based on the result of the name and DOB search.

In order to complete the fingerprint 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, submit a full and complete set of fingerprints, request a copy be sent to the agency listed below, and pay a fee of $25.00 to the fingerprinting services company.

Once this process is completed the information on my fingerprint criminal history record may be discussed with me.

Please TYPE YOUR FULL NAME to indicate that you acknowledge to the terms below *
Acknowledgement: I hearby certify that all information provided in this consent form is true, correct and complete. If any information proves to be incorrect or incomplete, I understand that this will be grounds for denying or terminating my ability to provide volunteer services for Pearsall ISD. I agree that I have read and understand the above information and all information in this form.
Your answer
Today's Date *
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