Volunteer On-Line Inquiry Form

Please fill out the information requested below, and we will contact you to set up an appointment.

First name:
Last name:
Address:

City:
State:
Zip:
Primary phone:
Alternate phone:
E-mail:
Re input e-mail:
Briefly describe the types of activities that you would like to do.

Briefly describe any skills that might be useful. (CPR, teaching, typing, etc.)

After registering, someone will contact you. Please make certain that your contact information is correct. Required fields are in red.

Northern Vermont Chapter — 29 Mansfield Ave. — Burlington, VT 05401
In VT: 800-660-9130 — Outside VT: 1-802-660-9130
Fax 802-660-9136