Step 2 - Read & agree to background check

Please read the following Background Check Details prior to filling out your background check. Then click the "I Agree" button at the bottom of the page & fill out the form below!
When answering the questions on the Background Check Consent Form, please explain any conviction whose record was expunged under Federal or State law.  Documentation regarding a court ordered expungement must be provided with this consent form.

* Minor traffic violations must be included if there was an arrest involved.

* Violations involving DWI, DUI, Open Container, and Driving While License “Suspended/ Invalid” must be listed.

Send an email to if any additional information is necessary. Include incidents that may not appear on your record at this time.

Important: For purposes of volunteering/employment, convictions include sentenced to confinement, paid fine, time served, placed on probation (includes deferred adjudication), court ordered restitution, date of Felony or Misdemeanor offense, Offense Class, City and State Punishment. (See Falsification Policy below.)

DOCUMENT REQUIREMENTS: You are required to provide with this questionnaire a disposition for each criminal charge you report in Questions 23, 24, and 25. A disposition is a statement of the charge, date, and the results of the case. If the charge was dismissed, the disposition must state the reason for dismissal. Dispositions can normally be obtained from the clerk of the court having jurisdiction over the case.

New Hope Church Questionnaire Falsification Policy:
It is important that volunteer applicants provide accurate information in this Questionnaire. Failure to list any criminal conviction or other important information is considered falsification of the questionnaire and will result in disqualification for the volunteer/employment opportunity.

What convictions must be listed?
All convictions handled in adult court must be listed, no matter when or where they occurred. In Texas, if you are 17 years old or older, the case is always handled in adult court. If you are under 17, it still maybe handled in adult court. 

Examples of minor traffic violations are speeding, running stop signs and no seat belts. Some (but not all-inclusive) examples of crimes which are not minor traffic violations and must be listed are DWI, DUI, Hit and Run, Assault with a Motor Vehicle, Reckless Driving, Open Container and Driving While License is suspended.

What is a conviction?
For New Hope Church purposes, a conviction is a judgment or a verdict, a plea of guilty or nolo contendere (No Contest), and/or a judicial finding or guilt substantiated by the evidence, which results in the payment of fines, forfeiture of collateral or bond, restitution, deferred adjudication, probation, community supervision, confinement, suspended sentence, or any other penalty imposed by a court of law or agreed upon by the accused. This includes instances where a pardon or a reprieve has been granted for any reason other than proof of innocence. If you have a case that was handled by deferred adjudication, it must be listed in your application, regardless of whether you think it is still on your record.

Military Convictions:  Convictions by court martial for criminal offenses must also be listed.

Failure to Appear: If you were convicted of a routine traffic violation or other offense and did not pay the ticket on time or failed to appear in court, you may have been charged with and convicted of Failure to Appear. Failure to Appear is a separate crime and must be listed.

If you have any questions concerning what must be listed in this Questionnaire, please contact Volunteer Team Manager Debbie Farquhar at 281-604-4000.

Background Check Agreement and Falsification Policy Acknowledgement:

I certify that I have read and understand the above explanation of the New Hope Church Policy on Falsification. I further certify that my answers on this Questionnaire are true, complete and correct to the best of my knowledge and that I have not evaded or omitted any part thereof to reflect an untruth. In addition to these facts, I understand that certain factors may be taken into consideration in regards to any past negative criminal discoveries. When considering these issues, the ultimate deciding factor rests on the Director of Operations and Church leadership’s discernment. 

I agree to have a background check conducted on me for the sole purpose of a volunteer/ employment opportunity. I also understand that additional re-checks may be conducted if the initial check is approved. I fully understand that falsification constitutes grounds for refusing (if discovered after approval has been granted) and/or terminating any New Hope Church volunteer/employment opportunities. 

I understand that these searches will be used to determine work assignment or employment eligibility under the Church's employment or volunteer policies. Therefore, I authorize and consent for a full release of records (either orally or in writing) to the authorized representatives of the Church. In addition, I release and discharge the Church and its agent and associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs expenses or any other charge or complaint filed with any agency arising from retrieving and reporting this information. I understand that according to the Federal Fair Credit Reporting Act, I am entitled to know whether employment was denied based upon the information obtained and to receive, upon written request, a disclosure of the background report. I also understand that I may request a copy of the report from my employer who has contracted with Protect My Ministry: 14499 N. Dale Mabry Hwy Suite 201 S Tampa, FL 33618.

Step 3 - agree & fill out background check info

After reading the above document, I fully understand its content and authorize the background verification. *
Full Legal Name *
Full Legal Name
Preferred Name *
Preferred Name
Aliases, Maiden Name, and or any other names used in the past *
Aliases, Maiden Name, and or any other names used in the past
Enter "None" if you have no other names used in the past
Exactly as it appears on social security card
Exactly as it appears on social security card
Exactly as it appears on social security card
Marital Status *
Date of Birth *
Date of Birth
Sex *
Current Address *
Current Address
Previous Address
Previous Address
enter "TEXAS" if this is the only state in which you have lived in the last 10 years
Cell phone *
Cell phone
Home Phone
Home Phone
Work Phone
Work Phone
Do you have any criminal charges currently pending? *
Have you ever been convicted of a crime (Misdemeanor or felony)? *
Are you on parole or probation, deferred adjuration, or under a pre-trial diversion agreement? *