By submitting this form I am confirming that all of the information being submitted is true and that I am the person listed on the account. If it is discovered that any information submitted on this form or during the use of this web site is not true, or that the person submitting this form or using the web site with this account is not, in fact, the person listed on the account, it will jeopardize the account holder's privilege to work and/or volunteer with children in the Diocese of Lake Charles.