Volunteer Application:
Acknowledgement-Authorization
for Background Check
Female
Male
1 Have you ever been convicted of a felony or are you currently serving a deferred adjudication probation term?
Yes
No
If yes, give following information:
2 Have you ever been convicted of a misdemeanor?
Yes
No
If yes, give following information:
3 Are you currently charged with (indictment or official criminal complaints accepted by County or District Attorney) a felony or misdemeanor?
Yes
No
If yes, give following information:
I certify that I have read and understand the above information and certify that all statements are true and correct.
I understand that all information will be verified in accordance with current Texas State Law and background check, motor vehicle reports
derived from Texas Department of Public Safety
As volunteer of Victoria County Long Term Recovery Group, I understand the VCLTRG requirements regarding background check and the need
for the above requested information from me to obtain such records.
