PVSA Application

In order to complete the application process, both the steps are mandatory

Place a copy of US Citizenship Certificate or Green Card in your personal folder and enter a link to that folder, in the form
Submit this form

Name

First Name

Last Name

Date of Birth

YYYY

Status

Lawful Permanent Resident

US Citizen

Award Year

PVSA year runs between Sept 1 to Aug 31st of the following year. For example: Enter 2022 if applying for period between 09/01/2021 to 08/31/2022

Number of Hours Volunteered

Enter hours volunteered during the 12-month PVSA period in decimals. For example 0.5 for 30 mins 1.0 for 1 hour

Award Category

Bronze

Silver

Gold

Lifetime Achievement

Link to the Citizen Status

Enter the link to Gdrive location

Comments or Additional Notes (if any)

Attestation Below

By typing your full legal name in this box you are attesting that all the information provided above is true. You also accept that all final decisions for approving the hours and awarding the PVSA rests with Deepti Designs

PVSA Application

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