Functionalmed

adding new life to years....

     Welcome to our volunteer Registration Page. Functionalmed.org maintains a list of volunteers throught the year to serve the elderly, low income, and disabled. We offer a rewarding experience in improving the quality of life for our most vulnerable population while providing excellent vocational training in construction and maintenance.

     The information requested on this page includes personal information for the purpose of criminal background checks. A criminal history does not automatically disqualify a volunteer, but may restrict certain opportunities. Conviction of the following offenses may potentially restrict your volunteer opportunity:

Texas Penal Code

  1. Title 5 (offenses against persons), including homicide, kidnapping, unlawful restraint, and sexual and assault offenses;
  2. Title 7 (offenses against property), including arson, robbery, burglary, theft, fraud, computer crimes, telecommunications crimes, money laundering, and insurance fraud;
  3. Title 9 (offenses against public order and decency), including public indecency; and
  4. Title 10 (offenses against public health, safety, and morals), including weapons, gambling, conduct affecting public health, and alcoholic beverage offenses.
  5. Convictions under federal law or another state or nation for offenses containing elements similar to offenses.

" * " indicates a required field.
* First Name
* Middle Name
* Last Name
* Street Address
* City
* State
* Zip Code
Phone
* Email
* Date of Birth (MM/DD/YYYY)
Drivers' License Number

By pressing the "SUBMIT" button below, you authorize Functionalmed.org to conduct a standard criminal history check for the purpose of qualification to access the elderly, low income, or disabled. This information is private and will not be released to any third party unless required by law.