Job Application

We appreciate your interest in the Roman Catholic Diocese of Syracuse. The Roman Catholic Diocese of Syracuse offers equal opportunities to all persons without regard to race, color, religion, age, sex, disability, national origin, ancestry, citizenship, military or veteran status, marital status, sexual orientation, domestic violence victim status, predisposing genetic characteristics or genetic information, or any other status protected by law. Applicants who require reasonable accommodation during the application process may contact Human Resources at 315-422-9092.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Street Address Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Are you over 18 years of age? REQUIRED Yes No Please fill out this field.

Are you legally eligible for employment in the United States? REQUIRED Yes No Please fill out this field.

In compliance with Federal Law, all persons hired will be required to verify identity and elgibility to work in the United States and to complete the required I-9 employment eligibility verification document upon hire.

Have you ever been convicted of a criminal offense (felony or misdemeanor)? REQUIRED Yes No Please fill out this field.

If yes, please explain. Please include in your explanation the date and place of conviction, and the crime for which you were convicted.

1. Has a civil complaint ever been filed against you that alleged sexual misconduct or child abuse by you or your participation in or facilitation of such activities (including internal complaints given to management or supervisors at places of employment)?

See above question. Yes No

If yes, explain. Please provide the date, nature, and place of the incident leading to the complaint; where the complaint was filed; disposition of the complaint; and identify by the name and title the person(s) who investigate the complaint.

2. Do you presently serve, or have you ever served, as a volunteer for any organization, entity or group in which you had contact with children or other vulnerable populations (e.g. elderly, mentally or emotionally handicapped, etc.)? REQUIRED Yes No Please fill out this field.

If yes, please provide the name, address, and phone number of the organization, period of volunteer service, supervisor’s name; and briefly describe your activities and/or duties.

3. Have you ever chosen not to renew or continue any employment or volunteer service, had your employment or volunteer service terminated, or been subject to any disciplinary action, for reasons relating to allegations of sexual misconduct or child abuse by you?

See above question. REQUIRED Yes No Please fill out this field.

If yes, please explain. Please include in your explanation the date, nature, and place of the occurrence(s) or allegations and the disposition of the matter(s). Also, identify your employer and supervisor at the time by name, address and telephone number.

Position Details

Position applied for: Please enter valid data.
Date you can start Please enter a date.
Have you ever worked for the Diocese before? REQUIRED Yes No Please fill out this field.
The Syracuse Diocese requires employees to participate in their Child and Youth Protection Training by attending a VIRTUS training session. Have you ever received VIRTUS training? REQUIRED Yes No Please fill out this field.
If yes, please provide the location and date: Please enter a date.
Education
What is the name and location of your high school? Please enter valid data.
Minor/Major and Degree Received Please enter valid data.
Year of Graduation Please enter valid data.
Name at Graduation Please enter valid data.
What is the name and location of the college you attended? Please enter valid data.
Minor/Major and Degree Received Please enter valid data.
Year of Graduation Please enter valid data.
Name at Graduation Please enter valid data.
Did you receive a post graduate degree? If so, where? Please enter valid data.
Minor/major and degree received Please enter valid data.
Year of Graduation Please enter valid data.
Name at Graduation Please enter valid data.
Did you receive other training? If so, where? Please enter valid data.
Minor/major and degree received Please enter valid data.
Year of Graduation Please enter valid data.
Name at Graduation Please enter valid data.

References

Please give the names of three persons not related to you, whom you have known professionally at least three years.
Reference 1
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Years Known REQUIRED Please fill out this field. Please enter valid data.
Reference 2
First Name Please enter valid data.

Last Name Please enter valid data.
Address Please enter valid data.
Phone Number Maximum 20 characters Please enter a phone number.
Years Known Please enter valid data.
Reference 3
First Name Please enter valid data.

Last Name Please enter valid data.
Address Please enter valid data.
Phone Number Maximum 20 characters Please enter a phone number.
Years Known Please enter valid data.

Are you applying for a position in the Catholic Schools? REQUIRED Yes No Please fill out this field.

Are you applying for a Teaching, Guidance or School Administration position? REQUIRED Yes No Please fill out this field.

If yes, please fill out Teachers/Substitute Applicants. If no, skip to Certifications:

Teachers/Substitute Applicants

Employment History

List all your work experience (starting with your most recent employer). Please account for all periods of unemployment in this section.
Most Recent Employer

Date Employed From & Date Employed To Please enter valid data.

Salary Start & Finish Please enter valid data.

Employer Name Please enter valid data.

Address Please enter valid data.

Phone Number Please enter a phone number.

Title Please enter valid data.

Name of Supervisor Please enter valid data.

Briefly describe your job duties and work experience: Please enter valid data.

Reason for leaving Please enter valid data.

May we contact your present employer at this time: Yes No

APPLICANT'S STATEMENT

NOTE: Any correspondence, interview notes and the results of the criminal background check and reference checks will be filed with this application. The use of this application form by the Diocese or an individual entity in no way indicates that employment is offered or necessarily will be offered by the Diocese of Syracuse. Eligible applicants may be offered employment by the local entity, which is the employer of record.

IMPORTANT: by my signature below, I certify that the information provided in this application is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I grant permission to check my background and references and release the Diocese of Syracuse and the Diocesan locations from any and all resultant liability. If welcomed as an employee, I will abide by the "Child and Youth Protection Policy" and the other policies and procedures of the Diocese of Syracuse. I understand that the acceptance of an offer does not create any obligation upon the Diocese to permit my continuing service.

I further understand that while not all positions are security sensitive, I acknowledge that all employees are required to undergo a criminal background check and "Child and Youth Protection Training".

I will be required to furnish proof of identity in association with the criminal background check.
I have read above statements. REQUIRED Please fill out this field. Please enter valid data.
Signature. REQUIRED Please fill out this field. Please enter valid data.

Job Application

Education

Reference 1

Reference 2

Reference 3

Certifications

Most Recent Employer

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