Safe Environment Application - Youth

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 form below the following steps must be followed:

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.

 

Student Information
Name
  •  
  •  
Date of Birth //
  •  
Parent Information
Name
  •  
Address
  •  
Email
  •  
Preferred Phone --
  •  
Alternate Phone --
  •  

Emergency Contact

Name
  •  
Phone --
  •  
Relationship
  •  

PARENT AUTHORIZATION


  •  

STUDENT VERIFICATION OF RECEIPT OF VOLUNTEER PERSONNEL POLICIES MANUAL


  •  

STUDENT VERIFICATION OF VIEWING EDUCATION VIDEO


  •  
//
  •  

FINAL VERIFICATION (PARENT/GUARDIAN)

By typing my name and submitting this application, I certify that I am the parent or guardian of the child or teen who is applying for the volunteer position on this application form.
  •  
Verification Date //
  •  

For security purposes, please enter the text that appears in the box below.
  •  
 
Online Giving

Online Giving

Secure and Convenient Donate now!