First-Time Participant Application – Catholic Kids Net Inc.

Catholic Kids Net Inc. First-Time Participant Application

Which program are you applying for?(Required)

Captivenia

Arcãtheos

Both

Contact Information

Name(Required)

First Last

Phone(Required)

Home

Mobile

Email(Required)

Enter Email Confirm Email

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Religious Affiliation(Required)

Religion

Church or Parish

Photo Upload

Please upload a simple portrait photograph of yourself.

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.

Position

Have you ever participated in a program with Catholic Kids Net, Inc.?(Required)

YES

What position are you applying for?(Required)

What interests you about the position for which you are applying?(Required)

What has prepared you for the positions for which you are applying?(Required)

What are some of the gifts and talents you would like to share?(Required)

History

Education History

Start & end dates

School name & address

Type of School

Name of program/degree

Program complete?

Complete for the highest level of education to date. Please start with the most recent and be as specific as possible.

Employment History

Please start with the most recent and be as specific as possible.

Start & end dates

Company name & address

Immediate supervisor name & phone number

Position held

Reason for leaving position

Volunteer/Ministry/Service History

List all paid and volunteer positions involving work with or around minors you have held, either with Church or non-Church organizations (e.g., Girl Scout leader, religious education instructor, youth minister, coach, etc.). Please start with the most recent and be as specific as possible.

Start & end dates

Organization name & address

Immediate supervisor name & phone number

Position held

References(Required)

Please provide names and contact information for two references as follows: (1) Employment Supervisor or Ministry Supervisor or Parish Priest and, (2) Personal reference (non-family member). These individuals may be contacted by Catholic Kids Net Inc. and/or their designee.

Reference name

Address

Daytime phone

How long have you known this person?

Has this person agreed to provide a reference?

Have you ever been accused of physically, sexually, or emotionally abusing a child or an adult?(Required)

YES

Please explain:(Required)

Carefully review each of the following statements:

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 this program.

I acknowledge receipt of the CKNet Camp Program Policy & Procedures and I agree to observe all of the guidelines and policies of this program.

I understand that it is my responsibility to read and comply fully with Catholic Kids Net Inc. Safe Environment Requirements before the commencement of volunteer/ministry work in any program.

I authorize this program to conduct a personal and professional background check for the purposes of my application.

CKNet, Inc. may contact any references, past and current employers, church, youth organizations, agencies where volunteer service has been completed, and any individual or organization that might be relevant to my desired position.

I hereby release all of the persons listed above from any and all liability for damages that might occur during the Catholic Kids Net Inc. contact with the individuals for purposes of employment or volunteer services screening.

I waive all rights to inspect information provided about me by the persons previously mentioned. I have also read and understood the information stated above in this release and am signing below of my own free will.

I understand that I must provide an original Criminal Record Check for Vulnerable Sector, in addition to an Intervention Record Check (or equivalent) specifically for Catholic Kids Net Inc. Failure to comply will result in my being barred from any contact with minors in all Catholic Kids Net Inc. programs.

I understand that Catholic Kids Net Inc. has ZERO TOLERANCE FOR ABUSE and takes all allegations of abuse seriously. I further understand that Catholic Kids Net Inc. cooperates fully with the authorities to investigate all cases of alleged abuse. Abuse of minors is grounds for immediate dismissal and possible criminal charges.

I declare that I have not perpetrated physical abuse, sexual abuse, emotional abuse, or neglect against a minor or a vulnerable adult, and that I have never been accused of these acts.

I understand that I can withdraw from the application process at any time.

I understand and agree that false statements and/or omissions regarding past conduct and/or present situation may be grounds for denial of the application to provide employment and/or volunteer services, and that refusal to inform this program of the contents of a sealed criminal record will result in the automatic denial of the application.

Consent

I acknowledge that my electronic signature below indicates that I have read, understand and agree to comply to all the above.

Participant Signature(Required)

Name(Required)

First Last

Date(Required)

Name

This field is for validation purposes and should be left unchanged.