Volunteer Application

Volunteer

If you have any questions or concerns, please contact Tom Alcorn, Senior Program Coordinator, by e-mail or call 802.786.4991 ext. 25.

PERSONAL INFORMATION

Yes, I have read this volunteer information before applying to become a volunteer.

New

Returning

Please select the year you started with Vermont Adaptive*
Note: Field is required for returning volunteers!

Which location will be the primary program where you will volunteer? Please choose one location for now, you can be added to other programs email lists at a later time:

First Name*

Last Name*

Date of Birth*

Address 1*

City*

County of Residence

State*

Zip Code*

Email*

Home Phone*

Format: XXX-XXX-XXXX

Cell Phone*

Format: XXX-XXX-XXXX

Occupation*

Place of Employment*

By continuing this application I'm acknowledging that Vermont Adaptive will perform a background check:*

Experience with disabled or special skills*

Are you a student?*

Date of expected graduation?

Shirt/Jacket Size*

INTERESTSABILITY LEVEL: BEGINNER :: INTERMEDIATE :: ADVANCED

Skiing*

Horse Program*

Camping*

Snowboarding*

Biking*

Fishing*

Snowshoeing*

Rock Climbing*

Paddle Sports*

Cross Country Ski*

Hiking*

Golf*

Fundraising/Office*

Others

Days of Preference*

Full Day or Half Days*

Available during school vacations?*

Emergency Contact*

Emergency Phone*

How did you discover Vermont Adaptive?*

What would you like to get out of volunteering for Vermont Adaptive?*

REFERENCES

Name*

Email*

Name*

Email*

Phone*

Relationship*

Phone*

Relationship*