RCS Safe Environment
Regis Catholic Schools is required to provide the information in this form to the Diocese of La Crosse as part of the Safe Environment program.  Please complete the entire form and turn in any additional paperwork as requested to be compliant with the Safe Environment program.
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First Name *
Last Name *
E-mail address *
Date of Birth *
What is your association with Regis Catholic Schools? *
What is your primary role? *
Is your primary role?
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Primary Affiliation *
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