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2. R-VIPs Volunteer Program Application

   The City of Rosenberg is excited to announce the launch of its new Volunteer Program, R-VIP (Rosenberg’s Volunteer Initiatives Program) designed to connect residents with meaningful opportunities that enrich our vibrant community. 

   To ensure a successful partnership between the City and our R-VIPs, several guidelines must be followed. Prospective volunteers are required to complete a volunteer application, meet age requirements (18 years old, or if a minor, be accompanied by an adult/guardian), and pass a background check before getting started. Please complete the form below to begin the R-VIP process.

4. DPS Computerized Criminal History (CCH) Verification Form (Agency Copy)
6. CONSENT TO CONDUCT DPS CRIMINAL HISTORY (CCH) VERIFICATION CHECK FOR VOLUNTEERING ACTIVITIES CITY OF ROSENBERG, TEXAS | DPS COMPUTERIZED CRIMINAL HISTORY (CCH) VERIFICATION FORM

   I acknowledge that a Computerized Criminal History (CCH) check may be performed by accessing the Texas Department of Public Safety Secure Website and may be based on name and DOB identifiers. Authority for this agency to access an individual’s criminal history data may be found in Texas Government Code 411, Subchapter F https://statutes.capitol.texas.gov/.

   Name-based information is not an exact search and only fingerprint record searches represent true identification to criminal history record information (CHRI), therefore the organization conducting the criminal history check is not allowed to discuss with me any CHRI obtained using the name and DOB method. The agency may request that I also have a fingerprint search performed to clear any misidentification based on the result of the name and DOB search.

   In order to complete the fingerprint process, I must make an appointment with the Fingerprint Applicant Services of Texas (FAST) as instructed online Crime Records General Information | Department of Public Safety (texas.gov) Review of Personal Criminal History or by calling the DPS Program Vendor at 1-888-467-2080, submit a full and complete set of fingerprints, request a copy be sent to the agency listed below, and pay a fee to the fingerprinting services company.

   Once this process is completed the information on my fingerprint criminal history record may be discussed with me. Acknowledge by signing below.

8. SECTION 1
10. Full Name (first, middle, last)
11. Email Address
13. Date of Birth
14. Last 4 digits of Social Security Number
16. Address
18. City
19. State
20. Zip Code
22. Phone Number
23. Date Volunteer Application Completed
25. Any other names previously used?
27. Types of Volunteer Programs You are Interested In

    1. Park Clean-Up
    2. Special Events
    3. Office Work
    4. Litter Pick-Up
    5. Any Volunteer Events
29. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
31. Electronic Signature
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field