Counselor Application Packet By uniting our Catholic faith and fun, we serve youth and young adults as they become joyfilled missionary disciples of Christ. 1. Register to counsel online 2. Complete this packet 3. Attend a counselor training
Virtus First time counselors: The Diocese requires that all individuals who work with minors be Virtus trained. Virtus training can be done online and it takes around 1.5 hours. Online training instructions can be found here: http://www.dmdiocese.org/hr/virtus%20training%20instruction%20- %2011_0%20IE.pdf This link is also available on our website on our counselor page. The certificate that you receive after completion MUST BE ATTACHED TO THIS PACKET. Your printable certificate will be available under Live Training on your online profile. If you have already been Virtus trained but never counseled, simply log in to your online Virtus account to find this documentation (http://www.virtus.org/virtus/) and attach it to this packet. *The St. Thomas More Center does not have access to your online Virtus account. If you are having trouble logging in or finding your certificate, please contact the diocese. Veterans: Congratulations! If you have counseled at CYC before and previously turned in your Virtus certificate to the St. Thomas More Center, you DO NOT need to attach proof of Virtus. Part 2: Background Screening Everyone, regardless of age, must complete this section. The required information is marked in yellow. You will sign a total of three times: twice on the first page and once on the second. Each is marked with a yellow line. Please review the Diocese of Des Moines Code of Conduct found on their website.
DIOCESE OF DES MOINES Background Screening Application S E C T I O N 1 TO BE COMPLETED BY LOCATION Check one box: Parish School Other Location Name: City: Contact Person: Telephone Number: Email: Parish / School ID # Virtus date: Check the category that best fits your position: Check all that apply: Applicant: anticipated start date Regular Contact with Children Candidate for ordination (deacon/seminarian) MINOR If you transport individuals for parish or school events, please complete the MVR section below: Priest / Deacon Motor Vehicle Report (MVR): Educator (BOEE licensed) Issuing State Employee (Chancery, School, Parish) Driver s License # Volunteer Name: First Middle Last Address: City State Zip County Phone Number: Email: Realizing, as Church, the importance of protecting youth and other vulnerable populations, I hereby consent and authorize an investigative consumer report to be conducted if deemed appropriate by the Diocese of Des Moines, any parish, school, or related Catholic institution. Public records may be used in this report, such as civil and criminal records and driving records, as well as personal interviews, as needed. I realize this inquiry may include information regarding my character, general reputation, a criminal background check and motor vehicle report. I release the Diocese of Des Moines, any parish, school, or related Catholic institution and their agents from liability associated with obtaining that inquiry. This consumer report will be used for employment/volunteer selection purposes and may be subject to the Fair Credit Reporting Act (FCRA). I may receive a free copy of this report. Before any adverse action is taken based on this report, I will receive a copy of the report and notice of my rights under the FCRA. Mindful of the importance of protecting children and other vulnerable persons, the undersigned acknowledges a truthful response of this information. I understand that past violations would not necessarily preclude the employment or volunteer position sought. Date of Birth: Social Security Number: (Social security # required for background check) Signature X Date: ACKNOWLEDGEMENT OF RECEIPT AND REVIEW OF THE CODE OF CONDUCT S E C T I O N 2 FOR THE PROTECTION OF CHILDREN AND YOUTH This is to acknowledge that I have received and reviewed a copy of the Code of Conduct for the Protection of Children and Youth of the Diocese of Des Moines. I understand that I am responsible for complying with the policies as stated and should refer any questions to my immediate supervisor or the Diocesan Human Resources Department (515-237-5085) for clarification. I further understand that the Diocese reserves the right to change, modify and/or revise any of the policies at any time. Employee s/volunteer s Signature X Employee s/volunteer s Name Parish/School/Agency Date Position/Description: Please complete page 3 Revised September 2013
Part 3: Insurance Card Please attach a photo copy of the front and back of your insurance card to this packet.
Part 4: References References are done completely online. Please choose two individuals (list their names below) and send them our reference form link. Please choose adults (that are not your family members, that have seen you work in an professional setting) to act as your references. Reference 1. Reference 2. Please send your references this link: https://goo.gl/forms/rmpzsdebiawjatbj1 This link is also found on our website on our counselor information page.
Part 5: Checklist Please make sure your packet is complete by reviewing this checklist. If you are a new counselor, please bring your completed packet to your counselor retreat. Returning counselors may mail their packets to: Catholic Youth Camp (Counselor Packet) 6177 Panorama Rd Panora, IA. 50216 I have attached my Virtus certificate to this packet or have previously turned in my certificate to Catholic Youth Camp in years past. I have completed the background screening application. I have attached a photo copy of the front and back of my insurance card to this packet. I have sent my two individuals the online reference link. Counselor Training information If you are a new counselor or have not counseled for three years, you are required to attend a counselor training. Veteran counselors are definitely welcome to join but are not required. Come ready to make new friends, try our brand new CYC activities, and prepare for an incredible summer! *You will select your counselor training date in your online application. **New counselors who do not attend a training, will not be able to counsel. Dates: April 8 May 6 June 2 Please arrive at 11:30 am. (Lunch will be provided) We will close at 5:00pm. If you can no longer attend your selected date, please email or call the office to sign up for the other date. Volunteers like you make CYC possible. We truly appreciate your interest in serving our youth. Feel free to contact the office at 515-309-1936 or office@stmcenter.com if you have any questions. Thank you!