St. Rose of Lima Religious Education
VOLUNTEER APPLICATION
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Employer
What age group are you most comfortable with?
Please Select
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Any Age
Please share any previous experience you have working with youth.
Please list any previous or current youth organizations, schools and/or parishes you have volunteered or worked with (include the timeframe of participation.)
References
Please list three references of individuals who are familiar with your character as it relates to working with youth.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Protecting God's Children Certification
All volunteers in the Diocese of Reno who have contact with minors and vulnerable adults while performing their tasks are required to complete the Safe Environment "Protecting Gods Children" mandatory training session and ongoing assignments. This includes twenty four monthly reading bulletins, a re-certification review and a background check. Please one:
I have completed all the requirements for this certification
I have not completed any of the requirements for this certification
I started this process but never finished
I am not sure if I have started or completed this
Other
Terms and Conditions
I understand that the information I have provided may be verified, if necessary, by contacting the persons or organizations named on this application or by contacting any person or organization that may have information concerning me. I hereby release and agree to hold harmless from the liability any person or organization that provides information. I also agree to hold harmless from liability in appropriately utilizing this application information, parish, school, the Roman Catholic Bishop of Reno and the officers, directors, employees and volunteers thereof. I affirm the forgoing is true and correct to the best of my knowledge.
Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: