Diocese of Paterson
PROTECTING GOD’S CHILDREN INFORMATION CHANGE FORM
Please save this completed form for your records and
email to
(Use “Tab” Key to move from field to field.)
PARISH, SCHOOL OR AGENCYCITY/TOWNDATE FORM COMPLETED
LAST NAME / FIRST NAME / ROLE / ACTION REQUESTED / Effective DATE(MM/DD/YY) / NOTES
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teacher, coach, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of ConductClear Internet Bkgrd Ck date
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct
Click to Select RoleVolunteer - SchoolVolunteer - ParishVolunteer - Catholic CharitiesPd Educators (Teachers, coahes, counselors, princ)School Employees (non-educators)Parish EmployeesCatholic Charities EmployeeSeminarianDeaconPriest / Click to Select ActionAdd New RecordClear Fingerprint DateClear Internet Background Check DatePGC Training DateInactivate Record At this LocationRemove Duplicate NameSigned Code of Conduct