Online Criminal History Form

I, , understand it will be necessary for Brazos
Bend Guardianship Services (BBGS) to conduct a background check regarding my criminal
history, personal references, and employment.
I authorize BBGS to obtain any needed information regarding my legal/criminal history,
character references, and employment from any state or federal agency, my employer, and
personal references for the purposes of participating in a volunteering program. Further, I
provide permission for BBGS to conduct the same investigation of my background in previous
states in which I have resided.

Please input your email address:

Please Sign Below:

Please Print Your Name Below:

Please list any other cities, states, and dates of residency during the past 10 years.