Print and complete the application below and submit to:

Vermont National Guard
Green Mountain Armory
 Attn: Colonel Suzanne Devoid
Vermont State Guard
Vermont National Guard Road
Colchester, VT  05446-3099

APPLICATION TO JOIN
THE VERMONT STATE GUARD
(Application Form - Web Download)

ZIP CODE: _____________

                 (VSG Use Only)

Name:                                                                                  Date of Birth:                          M  q   F  q

                                                                                                                                                           (MM/DD/YY)

Address:                                                                                                                                                
                                                                                                                             ZIP:                          
E-mail Address:                                                                                                                                 
Home Tel:                          Work Tel:                          Cell #:                          Fax: #:                         
Social Security Number:                                                               

Civilian Education Level:                                                               
Civilian occupation(s):                                                                                                                   
Special interest, talents, hobbies, avocations, licenses, etc.:                                                        
                                                                                                                                                            
Have you ever been convicted of a felony: NO      YES ___ (Explain):                                                      

Prior military service: YES      NO        ,   If yes what branch                                                               

Highest rank or grade attained:                         Job title(s):                                                                 

Insert years of service as applicable (YY - YY):

    q I certify that I am of good health and would be available to serve if asked by proper authority.
q I am interested in being considered for current membership CADRE STATUS in the VSG.
q I am interested in being placed on the waiting list for future consideration RESERVE STATUS in the VSG.
q I am interested in being placed on the waiting list for future consideration EMERGENCY STATUS in the VSG.
 

Applicant Signature:                                                                                              Date:                              
Position(s) considered:                                                                                          
Recruiter Signature:                                                                                              Date:                               
Recruiter's Unit:                                                                                                    

VSG Use Only:
Assigned to: Roster No. BN                 Co Assigned                 Position #                 Co Attached                   

VTSG Pam 600-1 (June 24, 2002)

VTSG Form 1-1