Safe Environment Forms

Attestation of Good Moral Character - DCF Requirement
For VPK/Pre-School Employees/Summer Camp DCF background screening. Must sign.

Appeal Process
The process to appeal a non-approved status for employment or volunteering.

Appeal Process Form
Form to submit to appeal a non-approved status for employment or volunteering.

Code of Conduct Acknowledgement and Agreement Form
To be signed when in receipt of Code of Conduct and agreement of code.

Credit Check Form/FCRA Bill of Rights (en Espanol)
If an employee/volunteer will be handling money or credit cards a credit check form must be signed, completed, processed and approved. A summary of your Rights under the Fair Credit Reporting Act.

Flyer for Assistance for Victims of Sexual Abuse
Download, print and post this flyer in a well-traveled area of your site. You may also post this information online.

MVR-Driver Form
If an employee/volunteer will be driving on behalf of this Diocese, their MVR (Motor Vehicle Report) must be approved. 
Complete the MVR form, attach a copy of your driver’s license AND the vehicle insurance Declaration Page from your insurance company showing the required amount of liability on the vehicle you will be driving. (Insurance ID cards are not accepted as they do not provide the amount of liability). 

• Amount of liability for driving children/students is minimum of $100,000 /$300,000 / $50,000 (to be renewed annually) 
• Amount of liability for driving personal vehicle for employment or volunteering purpose is minimum of $50,000/$100,000 /$ 25,000 (to be renewed every 3 years)
• To only drive a Diocesan Vehicle with children, you will need an MVR Form approved (to be renewed annually)

• To only drive a Diocesan Vehicle without children, you will need an MVR form approved (to be renewed every 3 years)

MVR documents are to be completed, signed and emailed to [email protected] by the parish/school for processing and approval. Please verify insurance coverage before requesting approval.

Driver Requirements Summary

	Driver Transports Children	Driver Does Not Transport Children
Minimum Age	Must be 25 years old to drive a vehicle with children.	Must be 21 years old to drive a diocesan vehicle.
MVR Frequency	Upon hiring and annually thereafter	Upon hiring and every three years thereafter
Minimum Coverage	$100,000 of bodily injury coverage per person $300,000 of bodily injury coverage per accident $50,000 of property damage coverage per accident	$50,000 of bodily injury coverage per person $100,000 of bodily injury coverage per accident $25,000 of property damage coverage per accident
Other	Provide copy of the vehicle insurance Declarations page from automobile policy annually. A driver will not qualify for driving on behalf of the Diocese if any of the following disqualifying offenses are found: 6 or more points on the driver’s license within the last 36 months Guilty of a DUI/DWI in the last 36 months Suspended/revoked status

• Notification will be sent to the site’s pastor, principal or designated person if a driver comes back as “non-approved” and the data will be submitted into the safe environment database by the Human Resource Department for future reference. 

• The Office of Safe Environment checks the driving records of all drivers whose information is submitted, but because of confidentiality issues, 
  we cannot share that information but only communicate the results based on the agreed upon criteria as to approved and non-approved. 
   If the driver would like to obtain a copy of his/her driving records he/she should contact the State of   FL Motor Vehicle Division directly.

 

Policy and Procedural Guidelines relating to Screening of Church Personnel
What an adult should do before you may begin employment or volunteer within the Diocese of Pensacola-Tallahassee. What an adult should do if already employed or volunteer within the Diocese of Pensacola-Tallahassee.

Privacy Policy Acknowledgement - DCF Requirement
For DCF VPK/Pre-School Employees/Summer Camp DCF background screening. Must sign.

To Report Sexual Misconduct by Church Personnel
For use by anyone wishing to file a report of sexual misconduct by Church personnel or volunteers.

VECHS Waiver Form (en Espanol)
All employees and volunteers that are fingerprinted for VECHS Level II, DCF and/or summer camps, must give permission for a background check/fingerprinting to be completed, the VECHS agreement waiver is acknowledgement for the Diocese of Pensacola-Tallahassee to complete this background check. 
This form is now an electronic signature within the VIRTUS safe environment program. If a paper copy is needed, please complete, sign and send to the 
Office of Safe Environment/HR Dept. at [email protected]. 
This form is not a background check, fingerprinting must be done to obtain a background check.  A volunteer or employee must still complete the process through their own parish, school or diocesan site office. The site location will provide information to VIRTUS or FieldPrint, to obtain the step for a successful fingerprinting.