St. Joseph Parish Catechist Application

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1 St. Joseph Parish Catechist Application For Virtus Audit Requirements For all Parish Catechists who volunteer teaching minors: Liturgy of the Word for Children, Catechesis for Early Childhood, Elementary, Middle School, and High School. Also includes all volunteers working with Vacation Bible School or RCIA for Children. Revised 2014

2 ST. JOSEPH CATHOLIC CHURCH Catechetical Ministry Application NAME: SPOUSE S NAME: ADDRESS: HOME PHONE: Cell PHONE: Occupation: Where employed Full time part time Best time to be contacted BIRTH DATE: Are you a practicing Catholic? YES NO Are you a certified catechist? YES NO I am volunteering to be a parish catechist as: Early Childhood: 3 yr old 4yr old 5yr old Sacrament Prep: 1st Year 2nd Year (Receiving 1st Reconciliation/1st Eucharist) Elementary: 3rd Grade 4th Grade 5th Grade Middle School 6th 7th 8th High School Yr I Confirmation Yr 2 Confirmation Substitute (which age group? Hi High School) Early Childhood Elementary Middle School RCIA for Children Liturgy of the Word for Children - Why do you want to be a Catechist? Are you willing to pursue continued Religious Education by working toward Diocesan Certification? Or renewal (60 hours of class time) Why or Why not? Page 1 - Rev 2014

3 You are asked to commit to continuing Faith Formation: Please indicate your interest Various Catechetical In-service Trainings at St. Joseph (TBD) San Pedro Regional Congress (one-day of workshops) Religious Education Congress Anaheim (3-days of workshops, liturgies, & more) Diocesan workshops specializing in area of ministry Work Experience in the Church: Previous Experience as a Religious Educator: Please list some previous churches, tasks and dates of involvement (Eucharistic Minister, Lector, Music, Environment, etc): If you could do anything for God without fear of failure, what would it be? For the protection of our children, please respond to the following: Have you been convicted of child abuse or sexual abuse or been involved in any activities related to molesting or abusing children/youth? No Yes If yes, please explain. What moving violations are on your driving record? Please list and explain. References: (Please provide name and phone number of three references, including a former supervisor) Year: Page 2 - Rev 2014

4 Application for St. Joseph Parish Catechist 6180 E. Willow St. Long Beach, CA (562) Fax: Since it is a mandate of the Church that all Roman Catholics are entitled to on-going religious education, the role of the parish Catechist is particularly significant. Thus it is the responsibility of the Parish to assure: That catechists be practicing Roman Catholics. Catechists continue to develop their skills in imparting the faith as it comes to us through the teachings of the Church. The Catechists themselves be enriched in their faith as they generously give their time and talents to the parish. The parish has a responsibility for the religious education of its members. For this reason we ask Catechists to: Fill out the attached application Be compliant with Virtus Protecting God s Children requirements (see checklist at the back of the packet) Be fingerprinted Commit themselves to on-going training, education and formation. Take seriously the witness they are to the parish, both to children and adults. Please Note: In accordance with Archdiocesan Policies, St. Joseph Church fingerprints all volunteers. I certify that all information provided in this application is true and complete to the best of my knowledge. I understand that any false information or omission may disqualify me from further consideration, and may result in my removal if discovered at a later date. By completing and signing this registration I am committing myself to: Give religious instruction to the children in the parish Attend Catechist formation sessions offered through the Parish and/or Archdiocese. Seek Archdiocesan certification as a Catechist. I authorize the Archdiocese, or its agents, to undertake any investigation, as it deems appropriate, in connection with this registration, including fingerprinting and a criminal background check. I am aware of the California Abuse and Neglected Child Reporting Act and that it requires me to report child abuse. This form will remain confidential, please print and sign form. Signature Date Page 3 (Rev 2014)

5 Please Print out, complete and take with you to get your fingerprints. Then bring a copy of the Live Scan back to the Religious education office.

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8 Boundary Guidelines For Junior High and High School Youth Working or Volunteering with Children or Youth Revised August 20, 2007 To ensure the safety of the children in the Archdiocese of Los Angeles, all youth volunteers, both junior high and high school students, including students who are already 18, who work or volunteer with children/youth in school or parish settings must receive training on these boundary guidelines before undertaking their ministry in the Archdiocese of Los Angeles and must sign this Code of Conduct form to verify that they understand their obligations. Code of Conduct For Student Workers/Volunteers I promise to strictly follow the rules and guidelines in this Code of Conduct. I understand that any action inconsistent with or failure to take action mandated by this Code of Conduct may result in my removal from my volunteer or work assignment. As a student volunteer I will: Respect the adults and supervisors with whom I interact. Safeguard at all times children or other youth entrusted to my care. Treat everyone with respect, loyalty, patience, integrity, courtesy and dignity. Take care to be positive, supportive and caring in my speaking, writing and actions with the children/youth. Avoid situations where I am alone with a child/youth. Use positive reinforcement rather than criticism or comparison when working with children/youth. Cooperate fully in any investigation of abuse of children/youth. Report suspected abuse to my supervisor, or if it involves my supervisor, report it to the principal or pastor at the location. Be aware that young people can easily become infatuated with a youth leader or an adult. If I sense that this is happening. I will not encourage it. I will make my administrator aware of it so that the supervisor can resolve the matter, including reassigning me to other activities. Maintain appropriate physical and emotional boundaries with the children/youth. Dress appropriately and not wear any clothing with offensive messages or pictures. As a Student Volunteer I will not: Endorse, during my ministry, any view contrary to the teachings of the Catholic Church. Commit an illegal or immoral act. Smoke or use tobacco products.

9 Use, possess or be under the influence of alcohol or illegal drugs at anytime while at work or volunteering. Verbally threaten or physically abuse anyone. Use profanity in the presence of children/youth. Use discipline that frightens or humiliates a child/youth. Touch a child/youth in a sexual, overly affectionate or other inappropriate manner. Sexually harass, request sexual favors from, or make sexually explicit statements to anyone. Place myself in a situation where my interaction with a child/youth cannot be witnessed. Participate in private visits, parties or other activities with the children/youth unless approved by my supervisor. Accept gifts from or give gifts to children/youth in my care without approval from my supervisor. Tolerate inappropriate or bullying behavior by a child/youth towards another child/youth. Fraternize with minors over the internet or through other forms of communication. We, the undersigned, have read and understand the Archdiocese of Los Angeles Boundary Guidelines for Junior High and High School Youth Working or Volunteering with Children or Youth and will abide by them at all times. We also understand and agree the parent/guardian will be notified at the time of any infraction requiring dismissal from any work or volunteer assignment at the school or parish or other setting where the student is working or ministering, and that he/she will be sent home at the expense of his/her parent or guardian. Print Name of Youth: Work or Volunteer Position: School or Parish: Signature of Youth Volunteer: Date: Signature of Parent/Guardian: Date: Signature and Title of Witness: Date: Helpful Links Office of Child & Youth Protection of the United States Conference of Catholic Bishops Charter for the Protection of Children and Young People Los Angeles District Attorney: Protecting Our Children

10 St. Joseph Parish Volunteers Safeguard the Children Forms/Audit Check List Application Received ( ) Year Completed Safe Environment Training for Adults (check all that apply): If you know the year you received your training/received your certificate, please indicate. To begin working with children you must complete the following: Virtus Protecting God s Children Adult Awareness Certificate on file: ( ) Year Fingerprinting on file with the Archdiocese of Los Angeles: ( ) Year Archdiocese of Los Angeles Guidelines for Adults Interacting with Minors at Parish or parish School Activities or Events: Read and Signed: ( ) Year After three years you must be recertified please take the following class which is good for 4 years( or keep current with the on-line bulletins and you will automatically recertified) Virtus Keeping the Promise Alive Recertification Certificate on file: ( ) Year Separate Certification given by Nancy so that you can teach our little ones you only need to be certified once. I have been certified to teach Virtus Teaching Touching Safety ( ) Year For those 18 and under who are helping in the classrooms: Completed Safe Environment Training for Children and Youth Under 18 (Check all that apply): Virtus Teaching Touching Safety ( ) Year Boundary Guidelines For Junior High and High School Youth Working or Volunteering with Children or Youth Read with parent and signed by youth: Parent signed: ( ) Year Office Use Only: Received Application: Date: Personal Interview: Date: Interviewer: Reference Check Completed: Date: Interviewer: Entered in VPIN: Date: Child Sexual Abuse Education Completed: Date: Page 5 -Rev 2014

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