Archdiocese of San Francisco

One Peter Yorke Way

San Francisco, CA 94109

Attention: Reverend Raymund M. Reyes

(Phone: 415/614-5611; Email: )

Office of the Vicar for Clergy

Personal Data Form for Non-Incardinated Priests

1.Today’s Date ______

2.Applying to the Archdiocese for the Following Time Period ______

  1. Name ______

(Last) (First) (Middle)

4.Birth date ______Place of Birth ______

5. Social Security Number ______

6.Ordination Date ______and Place ______

INFORMATION ABOUT RELIGIOUS ORDER/(ARCH)DIOCESE

Please spell clearly:

Incardinated in (Arch)Diocese of ______

OR: Religious Order ______

Your Superior/(Arch)Bishop ______

Address ______

______

His Phone (including country code/city code for dialing from the United States if applicable) ______

His Fax ______His e-mail address ______

INFORMATION ABOUT YOUR CURRENT ADDRESS AND PHONE

Please spell clearly:

Address ______

______

______

______

Phone ______

Fax ______

e-mail Address ______

7.Universities and Seminaries Attended, Dates and Degrees:

______

______

______

______

______

______

8.Previous Assignments – Please include Position, Place, Dates,
Name of Superior and Address:

______

______

______

______

______

______

______

______

9. Current Status of your Health:

Excellent ______Good ______Fair ______Poor ______

Please explain any limitations to your health:

______

______

10.Languages suitable for preaching:

English: Excellent ______Good ______Fair ______Reading Only ______

Spanish: Excellent ______Good ______Fair ______Reading Only ______

Other languages:

______Excellent ______Good ______Fair ______Reading Only ______

______Excellent ______Good ______Fair ______Reading Only ______

11.Please state why you wish to work in the Archdiocese of San Francisco:

______

______

______

______

12.Please describe any special experience, training and talents that should be considered in making your assignment:

______

______

______

13.Are there any special needs and/or difficulties of which we should be aware in

recommending an Assignment?

______

______

______

  1. Please list at least three names of those who could provide a letter of recommendation (use the back of this page for more space, if necessary):

(name) (address) (phone) (email

______

______

______

______

______

  1. Nationality ______
  2. Current Immigration Status ______
  3. Passport Number ______
    Type of Visa ______(attach copy)
    Sponsor, if you are here on an R-1 Visa ______
    ______
    Date of Expiration ______

If your application moves forward be prepared to provide the following documents:

A. A doctor’s report and date of last medical examination.

B. Proof of Vows and renewals, and certified English translation if applicable.

C. Birth Certificate, and certified English translation if applicable.

D. Baptismal Certificate, and certified English translation if applicable.

E. Resume or CV – Must be updated to include all employment and education. Please include addresses and time frame for each location.

F. Ordination Certificate, and certified English translation if applicable.

G. Color copy of All pages in Passport (Current).

H. Color copy of Visa.

I. I-94 cards

J. Employment Verification Letters – Job experience letters from any employers the past two (2) years.

K. Transcripts AND Diploma from Seminary – Provide proof of all religious education and training.

L. Education Degrees

M. Copies of Any “Other” Related Immigration Documents.

i certify that the information provided in this application is true, correct and complete to the best of my knowledge. I also give the Archdiocese of San Francisco permission to verify any of the information provided in this application and authorize previous and current employers and other organizations to release all relevant records and information.

  1. Signature: ______Date: ______

Aug 2017