If Special Ed or Other, Please Specify:
Current or most recent employer:
If yes, please provide the relative's name and relationship:
* Have you ever been convicted of, plead guilty or no contest (nolo cotender( to, or received probation, suspension, or deferred adjudication for a felony or offense involving moral turpitude?
If yes, please sate where, when and the nature of the offense:
Criminal History Record Information Request - Confidential
The TAHOKA Independent School District is required by Texas Education Code Chapter 22, Subchapter C to review the criminal history of applicant, employees, independent contractors, student teachers, and certain volunteers. The information requested below is necessary to obtain criminal history record information.
* Mailing Address
(City, State, Zip)
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.
Verification and Criminal History Record Information Request:
I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge, and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejections of my application or dismissal from subsequent employment.
I authorize the references listed on the previous page to give you any and all information concerning my previous employment and any pertinent information they may have personal and otherwise, and release all such parties from liability from any damage that may result from furnishing same to you.
I understand that Tahoka ISD is required by Texas Education code 21.917 to obtain Criminal History information on applicants selected for employment.
This application becomes the property of Tahoka ISD. Tahoka ISD reserves the right to accept or reject it.
|If you have a resume, please email it as a Word Doc or PDF to GMcFarland@tahokaisd.us.|