Safe Environment Application - Adult

Volunteer Form for Diocese of Fort Wayne-South Bend

THANK YOU for your interest in volunteering at St. Vincent de Paul Catholic Church. The Diocese of Fort Wayne-South Bend requires that all volunteers working with children or teenagers on a regular basis go through a screening process to ensure the safety of the children and teenagers at our parish.

BEFORE completing the application below the following steps must be followed:

Upon completion of this form, which is the first part of the application process, you will receive another link to complete a form for a criminal background check. Your application is not complete until the criminal background check is completed. 

AFTER completing your application, please email a picture of your driver's license to the parish's Safe Environment Coordinator at safe-env@saintv.org or click here.

Please note that completing the application process does not guarantee that you are able to participate as a volunteer with children or teenagers at the parish. If you have any questions, please contact the parish staff member with whom you are volunteering or the parish's Safe Environment Coordinator in the parish office at (260) 489-3537.

Basic Information
Volunteer Status
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Legal Name
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Date of Birth //
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Email
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Address
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Preferred Phone --
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Alternate Phone --
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Religion
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Emergency Contact

Name
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Phone --
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Relationship
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Background Information
Have you previously volunteered or been employed at a diocesan agency?
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* If YES, please provide the following additional information:
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Diocesan School/Agency Supervisor
--
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Have you ever been arrested or convicted of a crime that has not been expunged by court?
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* If you have ever been arrested for or convicted of a crime, other than a non-moving traffic offense, please indicate the nature, date and place of each arrest or conviction; sentence received; sentence served; the name of any probation or parole officer; and, any other facts or circumstances that you wish to provide below.
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Have you ever been investigated by a child protection agency?
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Message *If yes, please explain below.
Child Protection Agency Details
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Interests
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VERIFICATION OF VOLUNTEER APPLICATION


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VERIFICATION OF RECEIPT OF VOLUNTEER PERSONNEL POLICIES MANUAL


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VERIFICATION OF VIEWING EDUCATION VIDEO


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FINAL VERIFICATION

By typing my name and submitting this application, I certify that I am the person who is applying for the volunteer position on this application form.
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Verification Date //
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For security purposes, please enter the text that appears in the box below.
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