Safe Environment

Please read the Code of Pastoral Conduct and sign below to indicate your receipt and acknowledgement to the Diocese of Brooklyn. This acknowledgement will become a permanent part of the Diocesan records.
Statement of Acknowledgement

• I have received and have reviewed a copy of the Code of Pastoral Conduct. I understand that it is my obligation to abide by the provisions contained in the code.

• I understand that this code is not a contract and does not grant any rights to continued employment, ministry or volunteer service. I understand that the Diocese of Brooklyn reserves the right to change, modify and/or revise any part of this code at any time but that the Diocese of Brooklyn will notify church personnel of any changes to the code as soon as possible.

Signature _____________________________________________________________

Name (please print) _____________________________________________________

Home address _________________________________________________________

______________________________________________________________________

Telephone Number (h) ________________________ (w) ______________________
(cell)__________________________

E-mail address _________________________________________________________

Parish where you minister ________________________________________________

Parish Location _________________________________________________________
Date ___________________

Specific Position: (Please list one only, for example: Pastor, catechist, deacon, etc.)

_______________________________________________________________________

Introduction

For priests, deacons and pastoral ministers | For volunteers | For parish employees | Statement of Acknowledgement