The Dayton Independent School District is required by Texas Education Code Chapter 22, Sub-chapter C to review the criminal history of applicants, employees, independent contractors, student teachers, and certain volunteers. The information requested below is necessary and required to obtain criminal history record information. Do you agree to the submission of this form? (Selecting disagree, results in non-submission of this form, and a denial of volunteer action, in DISD.)

Reaquired field: Legal First Name

Legal Middle Name

Reaquired field: Legal Last Name

Maiden Name

Reaquired field: Social Security Number - No dashes

Reaquired field: Date Of Birth

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Reaquired field: Email Address - An email will be sent to this email to inform you of the status of your volunteer application.

Reaquired field: Phone Number

School Affiliation

Reaquired field: Teacher or Club Sponsor - Please provide the name of the teacher or Club Organizer that you are volunteering for. Example: if you are signing up to chaperone for your child's upcoming field trip you would put the teachers name here.

Valid Form of Identification - *Uploading your Driver's License is the preferred method, but you may bring a copy of your Driver's License to the Personnel Department at the Dayton ISD Administration Building, if unable to upload.

I am a District Employee of Dayton ISD at the following location.

Upload Signed copy DPS Computerized Criminal History (CCH) Verification - *Uploading your background check form is the preferred method, but you may bring a copy of your completed form to the Personnel Department at the Dayton ISD Administration Building, if unable to upload.

Reaquired field: Signature - I do hereby certify, warrant and affirm that I understand that I am responsible for following all rules and guidelines for Dayton ISD Volunteers. Typing your name below serves as your electronic signature, agreement, and gives us authority to submit this background check.

Reaquired field: Today's Date