Volunteer Application


THANK YOU FOR YOUR INTEREST IN VOLUNTEERING WITH Prevent Child Abuse Vermont!

Please complete the form and a member of our staff will contact you soon.

PCA Logo_VT_2C.png
Name *
Name
Address *
Address
Phone (Day) *
Phone (Day)
Phone (Evening) *
Phone (Evening)
Emergency Contact Phone *
Emergency Contact Phone
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
I am interested in volunteering as a leader in a:
Have you ever been convicted of a felony or a misdemeanor other than a minor traffic violation? *
I certify that all the information I have entered is correct and complete to the best of my knowledge. *
Background Check *
PCAV requires background checks of volunteers.