Vermont Adaptive Ski and Sports - Sports for Every Body

VOLUNTEER APPLICATION

*Required

PERSONAL INFORMATION
Which program do you want to volunteer with?
Full Name	*
Date of Birth
Address
City & State	Zip
Home Phone	*
Work Phone
E-mail	*
Occupation
Place of Employment
Can we call you at work?
Have you ever been convicted of a felony?
Experience with disabled or special skills:
INTERESTS	ABILITY LEVEL: BEGINNER :: INTERMEDIATE :: ADVANCED
Skiing
Snowboarding
Snowshoeing
Cross Country Ski
Horse Program
Biking
Rock Climbing
Hiking
Camping
Tennis
Boating
Golf
Fundraising / Office
Other:

Days of Preference
Full Day or Half Days
Available during school vacations?
Emergency Contact
Emergency Phone
How did you discover VASS?
What would you like to get out of volunteering for VASS?
REFERENCES
1. Name	Phone
Address	Relationship

2. Name	Phone
Address	Relationship

3. Name	Phone
Address	Relationship

YES	I would like to make a positive impact in the life of a young person with a disability as a mentor through the DS/USA Youth Sports Mentoring Program for this event, camp or program

NO THANKS	I currently am not interested in serving as a volunteer mentor in the DS/USA Youth Sports Mentoring Program.

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