Consent for Criminal Background Check
I hereby give my permission for Girl Scouts of Texas Oklahoma Plains, Inc. to obtain information relating to my criminal history record through IntelliCorp. The criminal history record, as received from the reporting agencies, may include arrest and conviction data as well as plea bargains and deferred adjudications and delinquent conduct committed as a juvenile. I also understand that the criminal history could contain information presumed to be expunged. I understand that this information will be used, in part, to determine my eligibility for a volunteer position with Girl Scouts of Texas Oklahoma Plains, Inc. I also understand that as long as I remain a volunteer of Girl Scouts of Texas Oklahoma Plains, Inc., the criminal history records check may be repeated at any time. I understand that I will have an opportunity to review the criminal history as received by Girl Scouts of Texas Oklahoma Plains, Inc. and a procedure is available for clarification if I dispute the record as received. I further understand, however, that in accordance with applicable provisions of Texas law I will not be allowed to keep or photocopy my criminal history record transcript. I, the undersigned, do, for myself, my heirs, executors, and administrators, hereby remise, release, and forever discharge and agree to indemnify and hold harmless IntelliCorp and Girl Scouts of Texas Oklahoma Plains, Inc., and each of their respective officers, directors, employees and agents, from and against any and all causes of actions, suits, liabilities, costs, debts and sums of money, claims and demands whatsoever, (INCLUDING CLAIMS FOR NEGLIGENCE, GROSS NEGLIGENCE, AND/OR STRICT LIABILITY OF INTELLICORP AND GIRL SCOUTS OF TEXAS OKLAHOMA PLAINS, INC.) and any and all related attorneys’ fees, court costs, and other expenses, resulting from the investigation of my background in connection with my application to become a volunteer with Girl Scouts of Texas Oklahoma Plains, Inc.
I certify that all information provided on this application is true and complete and that I have not knowingly withheld any information which might, if disclosed, affect my application unfavorably. I understand that any misrepresentation or omission of facts on this application may be considered justification for non-acceptance or dismissal if discovered at a later date.
I give permission for my references to be checked. I have reviewed the first page of this form and answered the questions to the best of my ability.
I understand that appointment to a volunteer position is contingent upon the completion and review of a criminal background check.
I have read the Girl Scout Promise and Law and will allow them to guide my actions.
By submitting this form you agree to the above statements.