Thank you for your interest in the Vermont Victim Assistance Academy! We are excited to announce that this training will be fully in-person in Waterbury, VT. 
 
As the field of victim services has evolved, we have too. We are confident that our team of exceptional Subject Matter Experts and Development & Planning Group have created a course that is both engaging and entertaining and will leave your victim services toolbox full! We have crafted a course that uses a combination of diverse presentations, activities and discussions that use real-life scenarios for maximum retention and engagement. 
 
For more specific information, we suggest taking a moment to read and understand the Program and Application Information on our website before completing the application. 
 
If you are unable to complete this application please reach out to us directly.
 
 
NOTE: In addition to this application, you must complete the Participant Agreement and the the Support for Learning letter.
 
Please  print, sign, and scan each document back to me Amber.King@ccvs.vermont.gov. Your application will not be complete without this submission. 
 
 
 
Support Contact: Amber King, Training Director (She/Her)
amber.king@ccvs.vermont.gov
p: 802-241-1250 x 114
 

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* 1. First Name

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* 2. Last Name

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* 3. What are your pronouns? For more information on pronouns and why they are important, click here.

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* 4. Phone Number

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* 5. Mailing Street Address

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* 6. Mailing City

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* 7. Mailing State

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* 8. Mailing Zip Code

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* 9. Email Address

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* 10. Name of Agency (and Department) or Organization. If unaffiliated, please enter "Community Member".

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* 11. Position Title. If unaffiliated, please enter "Community Member"

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* 12. Please indicate your interests in this training in regards to working with victims of crime. Please check all that apply:

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* 13. For what type of organization do you work? Please check all that apply.

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* 14. Your agency or organization primarily serves clients in which types of communities? Please check all that apply.

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* 15. How long have you been working or studying in your field?

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* 16. In what context might you come in contact with and/or serve victims or survivors of crime or offenders/responsible parties?

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* 17. The following question will help us understand your goals and intentions for completing the VVAA. Please include any information you believe is important for the participant selection committee to consider.

Please use 100 words or less to summarize how your participation in the VVAA will be a benefit to you, your organization and/or your community.

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* 18. Please select any additional accommodations you require from the list below. If you require something that is not listed, please indicate your request by selecting "Other" and providing us with specific information in the comment box.  We may contact you for further information, if necessary.

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* 19. NOTE: We plan to record each individual presentation throughout each day. 

The recordings will not be available to the public, they will be for current participants or potential late incoming participants.  The recordings will be available in case a work|life emergency calls you away from the presentation as well, so you are still able to view it. 

If being present during this private recording is problematic for you, please let us know right away!

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* 20. Applicant Signature:  This survey must be complete in order for your application to be considered.

By typing your name in the space below, you verify that all information given is accurate to the best of your knowledge, and that any false information will be sufficient cause for dis-allowance of your application.

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* 21. Applications are not considered complete until all required materials are submitted. The Participant Agreement and signed Support for Learning letter can be submitted via mail or email. 
Mailing Address:
Vermont Center for Crime Victims Services
Training Department
ATTN: Amber King
58 South Main Street, Suite 1
Waterbury, VT 05676

Or forms can be emailed to Amber King at: Amber.King@ccvs.vermont.gov.

Please be sure you have completed all of the following:

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