Parish Children Safe Environment Report

Parish Faith Formation

Children's Safe Environment Report Form
Due by January 31st

It is your responsibility to ensure that all children are trained during the school year. Children not trained by January 31st, will be expected to be trained by March 31st and a new report submitted.

Please direct any questions to Donielle Kube at dkube@dioceseofmarquette.org
Parish:*
City:*
Safe Environment Coordinator:*
Faith Formation Coordinator:*
If you are reporting for more than one parish, please indicate which additional sites in this section.
This is the ______________ report for the school year.*

FirstMake-up trainingOther
If you are reporting make-up training, are you reporting all children trained or just those who missed the training earlier in the year?

All children trained in this school yearJust those who missed the initial training sessionOther

Type number of students into fields.

	Total Number of Children in the Class	Total Children Opted Out of training
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
High School

Total Number of Children in the Class
Total Number of Children Who Have Opted Out of the Training
Total Children Eligible to be Trained
Total Children Actually Trained (total number of children in the class minus total number of children who Opted-out)*
Total Children Who Have Not Been Trained
Do you have a signed parental opt-out form in the student's file?*

YesNo
What is the plan for training children who missed the training?*
Date training was completed*
Date of form Submission*
The Materials were:*
Comments:
Should be Empty: