Safe Environment Application - Adult

Volunteer Form for Diocese of Fort Wayne-South Bend

THANK YOU for your interest in volunteering at St. Elizabeth Ann Seton 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.

In order to apply to volunteer, please complete the four steps listed below. Once all four steps are completed,your application will be reviewed by the parish's Safe Environment Coordinator, and, if approved, the oganization that you are volunteering for will be notified. 

  1. Complete Training Modules
    1. New Volunteers: Click here to create an account and begin your training modedule with Catholic Mutual Group (CMG).  For more information about creating an account with CMG, click here.
    2. Five Year Renewal Volunteers: You should have received an ID and PASSWORD when you were informed that your volunteer status was up for renewal. Please use the ID and Password given. PLEASE DO NOT CREATE A NEW ACCOUNT. If you have forgotten the ID or Password, please email the Safe Environment Coordinator at cyaney@seasfw.org or click here. Once you have your ID and Password, click here to begin your traning module with Catholic Mutual Group. 
  2. Send photo of your driver's license to the parish's Safe Environment Coordinator at cyaney@seasfw.org or click here.
     
  3. Complete and Submit the Volunteer Application below.
     
  4. Request Criminal History by clicking the link that appears after submitting your Volunteer Application in step 3 above. Note: This must be done on a laptop or desk top.

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 260-432-0268 or at cyaney@seasfw.org or click here.

Basic Information
Volunteer Status
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Legal Name
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Date of Birth //
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Email
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Address
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Preferred Phone --
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Alternate Phone --
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Religion
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Emergency Contact

Name
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Phone --
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Relationship
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Background Information
Have you previously volunteered or been employed at a diocesan agency?
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* If YES, please provide the following additional information:
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Diocesan School/Agency Supervisor
--
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Have you ever been arrested or convicted of a crime that has not been expunged by court?
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* If you have ever been arrested for or convicted of a crime, other than a non-moving traffic offense, please indicate the nature, date and place of each arrest or conviction; sentence received; sentence served; the name of any probation or parole officer; and, any other facts or circumstances that you wish to provide below.
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Have you ever been investigated by a child protection agency?
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Message *If yes, please explain below.
Child Protection Agency Details
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Interests
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VERIFICATION OF VOLUNTEER APPLICATION


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FINAL VERIFICATION

By typing my name and submitting this application, I certify that I am the person who is applying for the volunteer position on this application form.
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Verification Date //
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