REGISTERED CAREGIVER APPLICATION INSTRUCTIONS
BE SURE TO CAREFULLY READ THE PROGRAM INFORMATIONWHICH HAS BEEN PROVIDED WITH THIS APPLICATION OR ISAVAILABLE ON OUR WEB SITE AT WWW.DPS.STATE.VT.US.
2.Complete the Application Form in ink.3.Complete the Criminal Record Release Form and have it notarized.4.Arrange to have your digital photograph taken. The digital photograph will beused for your Registry Identification Card. You can use your own digitalcamera, have a digital photograph taken by a studio/store that takespassport photos, or you can arrange to have your photograph taken by theVermont State Police. (Call 802-241-5115 to make arrangements to haveyour photo taken by the State Police.)
Make sure that your digitalphotograph is taken using a .jpeg format.
Have the photo copied to afloppy disk or CD. Label the disk or CD with your name and date of birth andinclude it with your application.
VSP stations are not available to take the photograph that willaccompany your application. You may get your picture taken anywhere thatoffers passport photographs or any private individual with a digital cameracan take the picture. The file submitted must be in .jpg format.5.Enclose a check or money order for $50 (non-refundable) made payable tothe Department of Public Safety. The Registry cannot accept cash, creditcards, or installment payments.6.
the completed application and the
record check release formalong with your check and digital photograph to:Marijuana RegistryDepartment of Public Safety103 South Main StreetWaterbury, Vermont 056717.
Your application cannot be processed by the Registry until it iscomplete. A complete application includes the completed forms, acheck for $50 (non-refundable), and a digital photograph.
8.Please call the Registry at 802-241-5115 if you have any questions.
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