HOUSTON INDEPENDENT
SCHOOL DISTRICT
VOLUNTEER ACCESS TO POLICE RECORDS
School Site Requesting Information Date
Principal’s Name Phone No.
Revised
If you have ever been convicted or received
probation or deferred adjudication for a felony offense involving capital
murder; murder; voluntary or involuntary manslaughter; any felony theft
offense; indecency with a child; injury to a child, elderly, or disabled
individual; kidnapping; aggravated kidnapping; aggravated sexual assault;
aggravated assault causing serious bodily injury; sexual assault of a child;
aggravated robbery; any felony where a deadly weapon was used or exhibited; any
felony related to the manufacture, delivery, or possession of marijuana, a
controlled substance, or a dangerous drug, or any felony related to
pornography, or obscenity, you will not be allowed to volunteer in HISD. Parents who do not pass the criminal history
check are still encouraged to participate in their children’s education, such
as parent meetings and open houses at their children’s school(s).
IF YOU DO NOT
FULLY UNDERSTAND THIS STATEMENT, YOU MUST INQUIRE REGARDING THIS
INTERPRETATION. CALL THE HISD CRIMINAL
HISTORY OFFICE AT 713-892-7332.
Your signature below authorizes the
SIGNATURE: DATE:
Please Print or
Type:
Name:
Last First Middle Maiden
Social Security No.: _______|_______|________ Driver’s License No.: State:
Sex: Race: Date of
Birth:
Home Address:
Street City State/Zip
Daytime Phone No.:
Picture
Identification Required
School Volunteer Position:
q Field trip chaperone
q Over-night chaperone
q
q Speaker
q Tutor
q Other unsupervised activities
Please return to the VISITS
Administrator at your campus
for processing.
Please attach a
copy of
Please list any additional
schools where you plan to volunteer.
School Principal Phone No.