Guardian Application

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter a date.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Driver's License State REQUIRED Please fill out this field. Please enter valid data.

Driver's License Number REQUIRED Please fill out this field. Please enter valid data.

Concealed License/License to Carry State REQUIRED Please fill out this field. Please enter valid data.

Concealed License/License to Carry Expiration Date REQUIRED Please fill out this field. Please enter a date.

Are you currently or have you ever been a Police Officer? REQUIRED Yes No Please fill out this field.

Have you completed any certification or formal training related to this role? REQUIRED Yes No Please fill out this field.

What skills would you bring to the Guardian team? REQUIRED Please fill out this field.

What other safety or security related work experience do you have? Please list the following: Organization/Program, Dates Involved, Contact Name/Phone for Reference. REQUIRED Please fill out this field.

Have you been accused, arrested, or convicted of any crime? REQUIRED Yes No Please fill out this field.

Have you been investigated by a state agency (CPS, Police, etc) for misconduct with a child? REQUIRED Yes No Please fill out this field.

Have you lost or been denied the privilege to carry a concealed weapon? REQUIRED Yes No Please fill out this field.

Do you have any life experiences that may hinder you from a productive ministry on the safety and security team? REQUIRED Yes No Please fill out this field.

Are you aware of any reason you should not serve on this team? REQUIRED Yes No Please fill out this field.

What organizations, ministries, or groups have you been a part of in the past 3 years? Please list the following: Name of the Organization/City & State, Leader Name/Phone, and Dates Served. REQUIRED Please fill out this field.

Emergency Contact Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Verification and Release

I recognize that St. Patrick Parish is relying on the accuracy of the information provided on this application form. Accordingly, I attest and affirm that the information I have provided is true and correct. I also acknowledge that it is a requirement of this position to clear the Diocese of Dallas Safe Environment program, and it is my responsibility to maintain/update this on a regular basis.

I Agree Please select this field.

Electronic Signature REQUIRED Please fill out this field. Please enter valid data.

I Accept REQUIRED I Accept this as my electronic signature Please fill out this field.

Date REQUIRED Please fill out this field. Please enter a date.

I authorize St. Patrick Parish to contact any person or entity on this application form to ascertain information, opinions, and impressions relating to my background or qualifications.

I Agree Please select this field.

St. Patrick Catholic Church

Guardian Application

Guardian Ministry Application