Personal Data Form for Non-Incardinated Priests
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 ______
- 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?
______
______
______
- 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
______
______
______
______
______
- Nationality ______
- Current Immigration Status ______
- 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.
- Signature: ______Date: ______
Aug 2017