PVSA (AWARD) APPLICATION FORM
Email *
Are you a US Citizen or Permanent Resident
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Are you over 5 year old
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If answer to both questions is "Yes', please proceed to complete following - 
Have you volunteered between 1-Jul-23 to 30-Jun-24?
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What is your legal name (printing on PVSA certificate)
How many total hours have you volunteered - 
list by organization. 
Ex.:  BSNA - 40 hrs; Seva Intl- 20 hrs; Lord Shiv Temple - 20 hrs, etc... 
What is your birth month and year?
Mailing address (for mailing certificate)? 
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