this determines whether the program-specific sections appear

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Contact Information

US State/Zip

Phone Number

Phone Number - Admin

Phone Number

Social Security Number

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Student Demographics
Your response to the questions below helps us create a more diverse and inclusive learning environment for all.

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Company Information

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Past UVM students have a Net ID. A 'Net ID" is a UVM identifier that combines your first initial and last name. E.g. for "Joe Thompson" the net id would be "jthompso"

For research purposes only

A UVM affiliate is a current student, faculty, or staff at UVM, or UVM Health Network Employee

Dietary restrictions?

We want to serve you a meal that meets your dietary needs
Certificate Option


In what year do/did you expect to complete your undergraduate degree?

Date must be after the 20th of the current month

RELEASE AND WAIVER OF LIABILITY: As a condition of accompanying rescue personnel on fire apparatus or ambulances, I hereby acknowledge and assume full responsibility for any physical injuries and/or other damage(s) that may occur while I am a voluntary occupant in such vehicles or while I am at the scene of any emergency or non-emergency situation with rescue personnel. I fully understand that when rescue personnel dispatches equipment in response to a fire, rescue or other crisis call that it means that rescue personnel are responding to a potentially hazardous situation which may result in my (or, in the case of a passenger between the ages of 16 and 18, my child's) exposure to known and unknown hazards. I understand that this includes exposure to and/or use of Fire apparatus/ambulance equipment that may break, malfunction or be used improperly by the operators of that equipment. I agree to immediately and fully obey all lawful requests and commands of the fire apparatus/ambulance organization leader and shall not participate in any medical treatment or care unless specifically requested by the assigned leader. I also understand that I may be exposed to certain confidential information. Accordingly, I will not reveal the identity of individuals, discuss the incidents with third parties or write about the incidents without the express written consent of the officers of the fire apparatus/ambulance organization. I agree to hold UVM, the fire apparatus/ambulance organization, and its officers, employees, and agents free and harmless from any liability, claims, suits or damages of whatever kind or nature that may be occasioned by the above-described events and waive any right of subrogation I may have. Such release shall not apply if liability for injury or damage arises from the gross negligence of UVM, the fire apparatus/ambulance organization or their officers, employees, and agents.

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