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Eucharistic Visitor Application

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Is this application for a new license or renew a current license?*
Name*
ex: St. Martin's, Anytown
Do you have the recommendation of your Clergy or Warden in Charge?*
Do you have the recommendation of a Deacon under whom you will function?*
(if available)
Do you have the recommendation of your Vestry or Bishop's Committee?*
If none, please be aware that Diversity & Reconciliation training is required within the next 18 months. Watch the events section of our website for upcoming Diversity & Reconciliation Training courses.
MM slash DD slash YYYY
This date is required. If none, please stop your application and visit https://diowestmo.org/admin/background-information-release-form/ to submit your "Criminal and Social Security Trace (Verified Plus)" application.
MM slash DD slash YYYY
This date is required. If none, please stop your application and contact Elaine Gilligan (hr-finasst@diowestmo.org) to request access to the Safe Church, Safe Community online coursework.
MM slash DD slash YYYY
I pledge to carry out this ministry to the glory of God under the authority of the Bishop of West Missouri, and with the integrity befitting this sacred trust.
Clear Signature