Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Circles of Accountability and Support (CoSA) Volunteer

  1. Description

    The Winooski Community Justice Center is looking for volunteers for the Circles of Support and Accountability Program (CoSA). As you may know, the State of Vermont Department of Public Safety has authorized vulnerable incarcerated individuals to return to their communities due to the COVID-19 pandemic. These individuals are often marginalized and have few, if any, natural social supports. During this difficult time of isolation and stress, the Winooski Community Justice Center has partnered with the Essex Community Justice Center to ensure that CoSA volunteers continue to provide this essential service. CoSA volunteers are often the key to creating meaningful connections and achieving successful reentry for those returning to our communities.

  2. Emergency Contact Information

  3. Agreement

    I understand and agree that submitting this application form does not automatically register me as a City of Winooski volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. Volunteers must be 18 years of age to apply. By submitting this form, I attest that the information I have provided on the form is true and accurate. I hereby authorize the City of Winooski and its designated agents and representatives to conduct a criminal background check causing an investigative report to be generated for volunteer purposes. I understand that this background check will be processed through one or both the following entities: Vermont Crime Information Center (45 State Drive Waterbury, VT 05671-1300 / Tel: 802 244 8727) - Southeastern Security Consultants Inc (1853 Piedmont Rd Ste 100 Marietta GA 30066 / Tel: 866 996 7412). I understand that the scope of the report generated may include, but is not limited to the following areas: verification of social security number and/or birth date, current and previous residences, employment history, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, and any other public records.

  4. By clicking yes, I hereby agree to the statements above and attest that all information provided by me is true and correct to the best of my knowledge.*

  5. Leave This Blank:

  6. This field is not part of the form submission.