Ministry to the Sick Application

SECRETARIAT FOR LAITY, FAMILY, AND LIFE
Ministry to the Sick and Homebound
Name

First NameMiddle InitialLast NameSuffix
Address

Street Address

Street Address Line 2

CityState

ZIP
Email Address
Occupation
Phone Number (Home)
Phone Number (Cell)
Parish – Name & City
Deanery
Are you registered in the Parish*
Have you completed the Safe Environment Training?*
Date Verified

MonthDayYear
Date
Have you been Fingerprinted through the Diocese?*
Date Verified

MonthDayYear
Date
Ministers to the Sick provide a pastoral presence and the Most Holy Eucharist to our sick and homebound parishioners. Requirements for this ministry are:
- Fully initiated Catholics, active members of a parish.
- Sufficient age, maturity and temperament to undertake this ministry.
- Have no impediment to receiving Holy Communion and participate in the Sacramental life of the Church.
- Physically able to exercise this ministry.
- Have a current mandate as an Extraordinary Minister of Holy Communion (EMHC) from the Bishop of Orlando.
- Fingerprinted and Safe Environment Trained and Verified.
- Recommended and approved by Pastor
- Be willing to go through the certification process for Ministers to the Sick through the Office of Pastoral Ministry
- If driving for ministry purposes, be a verified driver in compliance with diocesan Driver’s License Verification Policy and Procedure
Have you been trained and mandated as an Extraordinary Minister of Holy Communion?*
Do you hold a current mandate for the parish in which you are serving?*
Date of EMHC Training

MonthDayYear
Date
Location of EMHC Training
Why do you want to become a Minister to the Sick?*
When are you able to do ministry visits?

WeeklyBi-WeeklyMonthly
Which day of the week are you available to serve?

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Ministry to the Sick requires continuing education and spiritual growth. Your certification must be renewed every five years by attending 15 hours of continuing formation. Hours can be completed by attending Diocesan Mornings of Reflection, Diocesan seminars or conferences, or parish-based seminars, series, etc. Hours must be kept track of through the Continuing Formation Form available through the Office of Pastoral Ministry.
Are you willing to commit to this Ministry for at least five years?*

YesNo
Are you willing to complete the requirements for certification, including continuing formation hours?*

YesNo
Driver Verification

I have completed the diocesan Adult Driver Information Form and the Drivers License MVR Request Approval Form
Applicant Signature
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

SECRETARIAT FOR LAITY, FAMILY, AND LIFE

Ministry to the Sick and Homebound

Applicant Signature