"*" indicates required fields Is this application for a new license or renew a current license?* New license application Renewal license application Name* First Last Email* Home Church/City*ex: St. Martin's, AnytownDo you have the recommendation of your Clergy or Warden in Charge?* Yes No Do you have the recommendation of a Deacon under whom you will function?*(if available) Yes No If so, please enter the name and email address of said DeaconDo you have the recommendation of your Vestry or Bishop's Committee?* Yes No List the date of your last Diversity & Reconciliation Training courseIf 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 List the date of your last diocesan criminal background check (REQUIRED)*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 List the date you completed the Safe Church, Safe Community training coursework (REQUIRED)*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 Signature*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.CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
