Survey - FLDA Volunteer Application Form

taking on disability together

FLDA Volunteer Application Form

Personal Information

Please enter your contact information below. Required fields are marked with an asterisk.


*	First Name: Required
*	Last Name: Required
*	Email Required
*	Phone Number: Required

Volunteer Service Information

Question - Required - I'd like to volunteer with:
Please make at least 1 selection from the choices below.

	Helping at local Easterseals events
	Working with Adult Day Care clients
	Providing chef instruction to Culinary Arts High School students
	Clerical/Back Office support
	Collecting donations for drives
	Providing enrichment activities (music, art, dance) to children and adults
	Upkeep beautifying projects (flowering, painting, gardening, etc.)
	Other (specify below)

Question - Not Required - If you selected 'Other', please list below:

Question - Not Required - If you selected Events, please state which event(s) you are interested in. Select all that apply.

	Small Miracles Luncheon
	Golf Fiesta
	Festival of Chefs
	Mission Dinner
	Other

Question - Not Required - What languages do you speak? Select all that apply.
Please make at least 1 selection from the choices below.

	English
	Spanish
	French/Creole
	Portuguese

Question - Required - When are you available? All selections are based on weekday, regular business hours. Select all that apply.
Please make at least 1 selection from the choices below.

	Monday
	Tuesday
	Wednesday
	Thursday
	Friday

Question - Not Required - Have you ever volunteered for Easterseals?

Easterseals South Florida
1475 NW 14th Avenue, Miami, FL 33125-1692 | 305-325-0470
Easterseals and its affiliate organizations are 501(c)(3) nonprofit organizations.

Easterseals South Florida
1475 NW 14th Avenue
Miami, FL 33125-1692 | 305-325-0470
Easterseals and its affiliate organizations
are 501(c)(3) nonprofit organizations.