Employment Application

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Chamberlain • Kimball • White Lake • Plankinton • Stickney

Pastorate of the Diocese of Sioux Falls

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Please fill out the following form.

Select Your Parish:*

Father's name*

Mother's Name*

Father's Birth Date (MM-DD-YYYY)

Mother's Birth Date (MM-DD-YYYY)

Address*

Email*

Phone*

Child #1: Name, DOB, Grade, son/daughter

Child #2: Name, DOB, Grade, son/daughter

Child #3: Name, DOB, Grade, son/daughter

Child #4: Name, DOB, Grade, son/daughter

Child #5: Name, DOB, Grade, son/daughter

If you need to add more children, please continue in Child #5 box with additional children's names and information.

Special Needs: Allergies, etc.

Parent Initials*

I declare that the info I’ve provided is accurate and complete.

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Diocese of Sioux Falls

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605-734-6122

smk@sfcatholic.org

Main Office Hours:

Mon - Thurs: 9AM - 4PM

Fri: 9AM - Noon

Clergy Phone Directory is available during and after office hours in case of emergency.

Mailing Address:
PO Box 137,
Kimball, SD 57355

Physical Address:
409 S. Elm Street,
Kimball, SD 57355

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