Application for Ministry and Volunteer Service

Thank you for filling out this application, which helps the Diocese of Corpus Christi and other organizations affiliated with the Roman Catholic Church fulfill their commitment to the safety and well-being of children and vulnerable adults. The information you provide in this application will be treated with confidentiality. All those seeking ministry or volunteer positions are asked to complete a background check which may include a credit report or a motor vehicle report, before beginning service. 

* All sections of this form must be completed in order to be processed. 

Personal Information
Date of Application //
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Name
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Please include your full name including your middle name.
Address
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Social Security
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Date of Birth //
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Gender
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Drivers License #
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Driver's License State
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Contact Phone --
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E-mail
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Indicate the parish or school in which you would like to volunteer:
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Volunteer position you would like to hold:
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Have you resided in any state other than TX during the past 5 years? If yes, please list all states:
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Volunteer Experience
Please list your volunteer experience with other churches, civil or non-profit organizations below.
If you have no volunteer experience to date, please indicate here:
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Prior Volunteer Experience
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Please list 1. The organization you volunteered with. 2. Volunteer Duties 3. Dates of Service.& 4. Names and phone numbers of the contact person.
To be completed by all:
Have you ever committed, been accused of, or been convicted of child abuse, neglect or crimes against the elderly or disabled?
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Have you ever been subject to any court order involving an allegation of sexual, physical, or verbal abuse of a minor?
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If Yes, please provide offense, date of offense or conviction and location of court:
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As of the date of this consent form, do you have any pending charges against you?
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If Yes, please provide offense, date of offense or conviction and location of court:
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Has your drivers license ever been revoked or suspended?
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If Yes, please provide offense, date of offense or conviction and location of court:
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Other than the previous information provided, is there any other fact or circumstance, involving you or your background that would call into question your being entrusted with the supervision, guidance and care of young people? If yes, explain:
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If you answered Yes to any of the above questions, please explain here:
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Permission to run Criminal Background Check:
By submitting this form, I certify that the information contained herein is true to the best of my knowledge. I authorize the Diocese of Corpus Christi to validate the information provided on this form, including any criminal conviction record, I understand that it is my personal obligation in maintaining a safe environment for all, to notify my pastor, principal, or supervisor if I am arrested or convicted of a crime after signing this form. I declare that all statements contained in this application are true, and that any misrepresentation or omission is cause for rejection of my application or dismissal from ministry involvement. *A criminal background check will be run every three years, effective January 2012.
Name
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Date //
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