Diocese Volunteer Form Please enable JavaScript in your browser to complete this form.This form is to be completed and submitted in conjunction with completion of Safe Environment training and Background Check. All materials will remain at St. Mary's Catholic School. CONFIDENTIAL Name *FirstLastAddress *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLength of residency in Wyoming in Years *Home PhoneCell PhoneWork PhoneHas any allegation or complaint ever een made against you relating to physical abuse, sexual abuse, harassment or exploitation? *YesNoHave you ever been convicted of a crime of physical abuse, sexual abuse, harassment or exploitation? *YesNoHave you ever been convicted of a felony? *YesNoList activities you spent time volunteering with:IN THE COURSE OF MY DUTIES I WILL: Have access to children (under 18). *YesNoDrive a vehicle on school business. *YesNoHave unsupervised access to school cash over $100. *YesNoSubmit