Become a VARHA Class Aide

Name *
Name
Date of birth *
Date of birth
Address *
Address
Phone number *
Phone number
Alternate number (if applicable)
Alternate number (if applicable)
Digital signature
Note: The State of Pennsylvania now requires online Mandated Reporter Training for ALL employees (regardless of age) interacting with children. In addition, all employees 18 or older are required to complete certain clearance reports. Before working with our riders, you will be required to complete training at VARHA and state-mandated reports applicable to you.
Digital Signature of Applicant
Date *
Date
Date
Date