Criminal History Information Request

Criminal History Information Request

Confidential
The Frankston Independent School District is required by Texas Education Code Chapter 22, Subchapter C to review the criminal history of applicants, employees, independent contractors, student teachers, and certain volunteers. The information requested below is necessary to obtain criminal history record information.
Name *

First Name Last Name
Social Security Number *
Date of Birth *

Month Day Year
Date
Driver's License *
State and Number
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Sex *

Male Female
Ethnicity *

Black White/Other
Phone Number *

Area Code Phone Number
Email *
example@example.com
I understand that 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.
Signature *

Clear
Date *

Month Day Year
Date
Should be Empty: