CRIMINAL HISTORY RECORD INFORMATION ADDENDUM
Confidential*
The Kerrville Independent School District is authorized by state law to obtain criminal history record information on applicants the district intends to employ (Texas Education Code §22.083). The information requested below is necessary to obtain criminal history record information.
Name: Social Security number:
Date of birth: Sex: M F .......
Ethnicity: Black White Other
Address:  
City: State: Zip:
Driver's License Number: (required)         State: (required) 
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.

E-Signature:

Date:
*This form will be removed from the application and filed separately in the personnel office.

EEOC • Updated January 4, 2005