St. Rene Goupil Parish Volunteer & Background Check Form

St. Rene Goupil Parish Volunteer & Background Check Form

All parish volunteers are required to complete a background check and attend the Protecting God’s Children/Vulnerable Adults class. These important steps help us create a safe, caring environment for everyone in our community. The Archdiocese of Detroit requires this for all volunteers in every Catholic parish, and we are grateful for your commitment in helping us live out this responsibility together.
I. Personal Information

As a religious organization the Safety of children, Vunerable adults, Employees, Independant Contractors, Volunteers, Parishioners and the people we serve is of the highest importance. Therefore, Criminal History background checks must be conducted for all Archdiocese of Detroit Central Services, Parish, and School employees, Contractors and Volunteers.
Full Name*

PrefixFirst NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Years Residing in Michigan*
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Alias (If any) - Other Names You are Known by.
Home Phone

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Email*
example@example.com
Race/Ethnicity
Sex*

MaleFemale

Pursuant to the federal Fair Credit Reporting Act, I hereby authorize the above named entity, The Archdiocese of Detroit, and its designated agents and representatives to conduct a comprehensive review of my background through a consumer report and/or an investigative consumer report to be generated for the employment, promotion, reassignment or rentention as an employee, contractor, or volunteer. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: verificataion of Social Security numer; current and previous residences; employment history; including all personnel files; education; references; credit history and reports; criminal history; inculding records from any criminal justice agency in any or all federal, state, county jurisdictions; birth records; motor vehicle records, including traffic citations and registration; and any other public records.
Authorization and Signature
I, Authorize the complete release of these records or data pertaining to me that an individual, company, firm, corporation or public agency may have. I hereby authorize and request any present or former employer, school, police department, financial institution or other persons having personal knowledge of me to furnish the above names entity, The archdiocese of Detroit, and its designated agents with any and all information in their possession regarding me in connection with an application of employment or volunteer position. I further release the above named entity, The Archdioces of Detroit, and it related entities from all liability resulting from the furnishing of this information. I am authorizing that a potocopy of this authorization be accepted with the same authority as the original.
I understand that, pursuant to the federal Fair Credit Reporting Act, if any adverse action is to be taken based upon the consumer report, a copy of the report and a summary of the consumer's rights will be provided to me.

By typing or signing your name below you agree and authorize this background check.

Bodman 7_2024
Please type your full name*

First NameMiddle NameLast Name
Signature - Please sign your name*

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Date Signed*

MonthDayYear
Date
For Minor's - Under the age of 18.

Minor's please have parent/guardian fill out this form with you, parent/guardian will also need to sign at the end of this form.
Parental Consent and Authorization For Minor's Only.

I, the undersigned, am the parent or legal guardian of the minor named above. I hereby give permission to St. Rene Goupil to conduct a reference check, character screening, or other age-appropriate background screening necessary for my child to serve as a church volunteer.
I understand that the purpose of this screening is to ensure a safe environment for all individuals involved in church ministries. I understand that any information gathered will be kept confidential and used solely for volunteer screening purposes.
I further certify that the information provided by my child or myself to the church in connection with volunteering is true and accurate to the best of my knowledge.    I consent to the screening as outlined above   I understand that my child will not be allowed to volunteer without this consent.

         Minor's First Name   Minors Last Name   Parent/Guardian First Name   Parent/Guardian Last Name   Signature      Date
Email list agreement and terms.

By checking this box, I agree to receive parish volunteer updates, reminders, and notifications by email from St. Rene Goupil Parish volunteer programs.

I understand that:

I can unsubscribe at any time using the link in any email or by contacting the parish office.
My information will be used only for parish communications and will not be shared with outside organizations.
Reasonable steps will be taken to protect my personal information in accordance with privacy laws.
By opting in, I confirm that I give permission to be added to the parish email list.
Email Opt-in confirmation.

please click button. I confirm that I give permission to be added to the parish volunteer email list.
When you submit this form, you will be redirected to Virtus Online
to create an account or sign in and register for the Protecting God’s Children/Vulnerable Adults class. A Virtus account is required by all volunteers.
Should be Empty:

St. Rene Goupil Parish Volunteer & Background Check Form

I. Personal Information

Authorization and Signature

By typing or signing your name below you agree and authorize this background check.

For Minor's - Under the age of 18.

Parental Consent and Authorization For Minor's Only.