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Get Galena Park Isd Administration Building

917. Please complete this form and return it to the Galena Park ISD Administration Attn Pat Moye Human Resources and Communication Services 14705 Woodforest Blvd. GALENA PARK INDEPENDENT SCHOOL DISTRICT CRIMINAL HISTORY FORM By State Law the Galena Park Independent School District is required to obtain a criminal history record prior to you beginning your employment with the District Texas Education code Section 21. Houston TX 77015 or by faxing the form to 832 386-1450. I understand the information set forth below will be used by the District for the purpose of obtaining criminal history record information and will be used in determining eligibility for employment with the District. Campus/Department Position Full Name Print Last Address First Street City Social Security No Maiden County State Zip Date of Birth Sex Male Ethnicity Middle Female BlackHispanicAsianIndianWhite Driver s License Number State List all previous addresses beginning with the most recent if not enough space use reverse side of paper From/To / City or Town Signature. Houston TX 77015 or by faxing the form to 832 386-1450. I understand the information set forth below will be used by the District for the purpose of obtaining criminal history record information and will be used in determining eligibility for employment with the District. Campus/Department Position Full Name Print Last Address First Street City Social Security No Maiden County State Zip Date of Birth Sex Male Ethnicity Middle Female BlackHispanicAsianIndianWhite Driver s License Number State List all previous addresses beginning with the most recent if not enough space use reverse side of paper From/To / City or Town Signature.

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