Apply Online – Registry Check – Consent

Registry Check

  • Vermont Agency of Human Services - Adult Protective Services - 103 S. Main Street - Ladd Hall - Waterbury, VT 05671-2306 - AND - Child Abuse Registry Unit - 103 S. Main Street - Waterbury, VT 05671-2401 - FORM C
  • This consent form must be filled out completely and signed by the current employee, prospective employee, contractor or volunteer and kept on file at the requesting organization. The Agency of Human Services reserves the right to audit these consent forms at any time.
  • Current or Prospective Employee, Contractor, or Volunteer Information

  • This field is for validation purposes and should be left unchanged.