VAPLP Participant Confirmation

Name(Required)

First Last

Short Bio(Required)

where you live right now // who you are // what’re you excited for with VAPLP // fun fact

Photo of You(Required)

Max. file size: 50 MB.

Dietary Needs

COVID Vaccine Card(Required)

Please make sure your name and vaccinations are viewable and up to date.

Max. file size: 50 MB.

Below is our health & safety policy as of today's state of the pandemic. If you have any changes to support the health, safety, and comfort of our community in this space, please share below.

Participants, VCET staff, and guests must be up to date on COVID-19 vaccinations, as defined by the Center for Disease Control. As an extra layer of safety, you must have proof of a negative antigen or PCR test result within 48 hours prior to each program weekend. VCET will provide participants with at least four at-home testing kits – one for each weekend. Proof of a negative test result will need to be uploaded by 3pm each Friday. Each day of the program weekend, everybody will also complete a health & safety check-in, which includes attestation and temperature check. There will also be health & safety stations (including hand sanitizer, wipes, and tissues) throughout the workshop space. At this point, face coverings are optional. Your health & safety is our number one priority and this is subject to change based on CDC guidelines.

Vehicle Information

This will be used to obtain any parking passes for the program weekends.

Make

Model

Year

Color

License Plate Number

Travel Stipend + Reimbursement

Please read through the policy below. The following fields in this section inform what we need to distribute funds your way if you decide to opt in.

Opt In/Out(Required)

Travel Stipend

Travel Reimbursement

Neither: I would like to opt out of the travel stipend + reimbursement. I confirm that I will be paying for the cost of travel fully on my own.

Bank Name

Routing Number

Account Number

Please fill out this W-9

Please attach a voided check.

If you don’t have a voided check, no worries.

Max. file size: 50 MB.

Our Pod

What three songs would you like to add to our "party" playlist?(Required)

songs that make you wanna strut and drop towards liberation

What three songs would you like to add to our "slow down" playlist?(Required)

songs that make you wanna reflect and think deeply

Favorite snack?(Required)

Below is a list of activities for Weekend 3 at Wintergreen. We'll have time to party at the Discovery Ridge Adventure Center. Please rank the activites based on your first to last choice.

You can find details on the activity choices here: https://www.wintergreenresort.com/discovery-ridge/

Miniature Golf
Climbing Tower
Disc Golf
Ninja Warrior Course
Tubing Park
Hiking
Kayak / Paddleboard / Aqua Cycle

Mentorship

What do you look for in a mentor?(Required)

How important is it that your mentor shares your race/ethnicity?(Required)

Not a priority at all	Would be nice but if not that’s okay	Big priority

How important is it that your mentor shares your gender identity?(Required)

Not a priority at all	Would be nice but if not that’s okay	Big priority

How important is it that your mentor is part of the LGBTQ+ community?(Required)

Not a priority at all	Would be nice but if not that’s okay	Big priority

What're you interested in skilling up?(Required)

Anything else?

Recruitment + Selections Feedback

At VCET, we’re always learning, growing, and working to push the quality of our work beyond its current state, especially to better the experience for future applicants.

What is one thing that VCET did really well in its recruitment & selections process for VAPLP?(Required)

What can VCET improve upon and/or do differently with its recruitment & selections process for VAPLP? Alternatively, how could this experience better have supported you throughout the process?(Required)

Please sign the waivers + releases here