CATHOLIC LEADERSHIP INSTITUTE-Diocese of Springfield in Illinois

Team Application 2012

Instructions: To apply for a team role on CLI, please complete both sides of this application form and
provide two references using the Volunteer Reference form. All applicants must be in compliance with
Protecting Gods Children policies for the Diocese of Springfield in Illinois. The 2012 CLI program
begins with a Team meeting on the evening of Saturday, July 14.
TEAM APPLICATION
Name: _______________________________________________________________________________________Shirt
Size: ______________________________
Address: ____________________________________________________________________________________Date of
birth: __________________________
City, State, and ZIP Code:
_______________________________________________________________________________________________________
_____
Home Phone: ___________________________________Cell: _________________________________Work:
_______________________________________
Email:
_______________________________________________________________________________________________________
__________________________
Parish: ______________________________________________________________________Pastor:
_________________________________________________
Position:

Adult Team

Table Leader

Facilities Director

Facilities Team
Have you ever had your service to a parish, school, agency or institution terminated?
<INPUT TYPE=\ CHECKBOX NAME= Yes > MACROBUTTON HTMLDirectYes
CHECKBOX NAME= No > MACROBUTTON HTMLDirectNo

<INPUT TYPE=\

If yes, please explain:

___________________________________________________________________________________________
Have you been convicted or pleaded guilty to a misdemeanor or any offense that involves
embezzlement, fraud, stealing, robbery, violence or physical or sexual abuse, neglect or misconduct in
any form?
<INPUT TYPE=\ CHECKBOX NAME= Yes > MACROBUTTON HTMLDirectYes <INPUT TYPE=\ CHECKBOX
NAME= No > MACROBUTTON HTMLDirectNo If yes, please explain:
_______________________________________________________________________________________________________
__________________________________
Have you been convicted or pled guilty to a felony within the last ten years?
<INPUT TYPE=\ CHECKBOX NAME= No > MACROBUTTON HTMLDirect Yes <INPUT TYPE=\ CHECKBOX
NAME= No > MACROBUTTON HTMLDirectNo If yes, please explain:
_______________________________________________________________________________________________________
__________________________________
While a conviction record is considered, it is not automatic grounds for rejecting an application.
Circumstances surrounding the conviction are considered.
Describe any previous experience you have with CLI:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________

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Describe your present involvement in your parish:
_______________________________________________________________________________________________________
__________________________________
_______________________________________________________________________________________________________
__________________________________
List other catechetical or formation programs you have attended:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
____________________________________________________________________
Describe your current prayer life:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
Describe your strengths and weaknesses for each of the positions for which you applied:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
____________________________________________________________________

VOLUNTEER AGREEMENT AND CODE OF BEHAVIOR

Any material misrepresentation or deliberate omission of facts on my application will be justification
for refusal of a volunteer position or if already a volunteer, termination form that volunteer position.
By signing and submitting this application, I agree to abide by the policies of the Diocese of Springfield
in Illinois for the Catholic Leadership Institute (CLI) program. I understand that the diocese has a zero
tolerance for abuse and takes all allegations of abuse seriously. I further understand that the diocese
cooperates fully with the authorities to investigate all cases of alleged abuse. Abuse of minors is
grounds for immediate dismissal and possible criminal charges. I also understand that there are a
limited number of team roles for CLI and that not all applicants may be able to serve on the team.
CODE

OF BEHAVIOR
Each person will respect his/her dignity, self-worth and value in Gods eyes.
Each person will respect the dignity, self-worth and value in Gods eyes of other persons.
Each person will respect the physical property and possessions of other persons and
institutions.
Each person has a duty to report violations of the Code of Behavior.

Specific violations of the Code of Behavior include, but are not limited to, the following:
Possession or use of alcohol or any controlled or look-alike substance. An exception is noted for
sacramental wine only if it is used for the celebration of Mass.
Inappropriate sexual behavior including displays of affection as well as indecent clothing.
Using corporal punishment or inflicting any form of physical abuse
Theft, destruction or defacement of property
Being in an unauthorized area including leaving the program grounds without permission
Verbal abuse and inappropriate language
Violence of any kind
Violating curfew
Any act defined as criminal under the law

Violations of this Code of Conduct must be reported to the CLI Leaders and/or the Office for Vocations
as soon as possible.
I have read and understood the above statement.
Signature: ______________________________________________________________________________Date:
________________________________________
Printed Name: _________________________________________________________________________

TEAM ROLES
ADULT TEAM: Under the direction of the Associate Director of the Office for Vocations, the Adult
Team leads catechetical sessions, supervises all activities, serves as a resource for Table Leaders,
tasks Facilities Director as needed, and must be 21 years old or older.

TABLE LEADER: Under the direction of the Adult Team, the Table Leaders build rapport with all

members of the small groups, participate in all activities with CLI participants, facilitates table
discussions, participates in morning workshops, leads afternoon small group sessions, assists with
evening activities, prepares small group for prayer and community responsibilities, and lead by
example at all times.

FACILITIES DIRECTOR: TO coordinate the behind-the-scenes work of CLI, the Facilities Director
oversees the Facilities Team to organize evening socials and recreational equipment, coordinates
program materials for the adult team, provides security, maintains the safety and cleanliness of
the facilities throughout the program, and must be 21 years old or older.

FACILITIES TEAM: Under the Facilities Director, the Facilities Team sees to the behind-the-scenes
needs of CLI.
Send Completed Application To: Missy Mark, 250 Keeneland Ct., Collinsville, IL 62234
Deadline: May 31, 2012