EmailMe Form - Socorro Independent School District

Volunteer Name/Nombre de voluntario

First Last

Are you a District Employee

Yes

No

Are you a College Student seeking class credit? If yes, please apply through the SISD Human Resources Department

Yes

No

Phone/Teléfono; if district employee please use your district phone number

### - ### - ####

Email/Correo electrónico; if district employee, please use district email *

Address/Domicilio *

Street Address City State / Province / Region Postal / Zip Code

Date of Birth/Fecha de Nacimiento *

MM / DD / YYYY

Social Security Number/Numbero de Seguro Social *

United States of America issued identification number (valid drivers license, state ID, passport, military ID)/ID de los Estados Unidos *

State or issuing Agency/Estado o Agencia *

Name of School/Schools or Department where you wish to volunteer your services/Escula(s) donde vay a participar *

Please make your selection/haz tu selección *

Press Ctrl key, for more than one selection.

Are you a Booster Club or a PTA Officer?

SISD Parent Organization Officers Only

If you are an officer of a booster club or PTA, please name your position on the board i. e. President, Vice President, Secretary, Treasurer, etc.

Name of Booster Club or PTA

Have you ever been arreste/Hay sido arrestado *

I understand and agree that SISD may obtain any criminal history record information pertaining to me. The district may obtain such information from the Department of Public Safety.
Have you received a deferred adjudication or been convicted by federal, state, or other law enforcement authorities or pleaded nolo contendre for violation of federal law, state law, county or municipal law, regulation or ordinance? (You must include any offense for which a fine of $100.00 or more was imposed. Do not include any offense that occurred before your eighteenth birthday.) Comprendo y acepto que el Distrito de Socorro puede obtener cualquier información e historial criminal relativo a mí. El Distrito puede obtener cualquier información del Departamento de Seguridad Publica.
¿Ha recibido una sentencia diferida o fue condenado por las leyes federales, estatales o de otros servicios de seguridad o se declaró nolo contendere por la violación de la ley federal, la ley estatal, del condado o municipal, regulación u ordenanza? (Usted debe incluir cualquier delito por el cual se impuso una multa de $100.00 o más. No incluya ninguna infracción cometida antes de sus 18 años.)

If yes, please explain the types of offense(s)/Explica tus offensas

Applicant Signature/Firma Electronica *

Electronic Signature/Firma Electronica

By checking the box above, I hereby give my voluntary consent to a criminal history check, pursuant to Texas Education Code §22.0835. I understand that certain information obtained as a result of this criminal history check may preclude my participation in the SISD volunteer program. I agree to conform to all district policies and procedures. I certify that all the information in this application is true and correct, and I further understand that my misstatement or omission of information may be grounds for disqualification. I understand this application becomes public record and is subject to disclosure. I understand that I have the right to review and challenge any negative information that would adversely impact my application. Further, I hereby hold harmless, release, and fully discharge SISD, its agents, officers, or employees, from any and all liability, and claims, causes of action, costs and expenses which be attributed to my participation in the SISD Volunteer Program and/or any and all liability for the criminal history check and any action as a result of information obtained through the criminal history investigation.
Por lo presente doy mi consentimiento voluntario a una verificación de antecedentes penales, de conformidad con el Código de Educación de Texas § 22.0835. Yo entiendo que cierta información obtenida como resultado de esta verificación de antecedentes penales puede impedir mi participación en el programa de voluntariado SISD. Estoy de acuerdo en cumplir con todas las políticas y procedimientos del distrito.