Volunteer

Name

First Middle Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Employer

What are your interests in Volunteering with FSPC

Email

In Which Region/count(ies) are you willing to volunteer?

Describe your related professional and/or volunteer experience:

If you’re a loss survivor, briefly describe your loss, the time frame, and your process for dealing with your grief (e.g., support groups, professional counseling):

What skills, interests, and abilities do you hope to use as a Florida Suicide Prevention volunteer?

How did you hear about Florida Suicide Prevention Coalition?

As a Florida Suicide Prevention Coalition volunteer, I will serve without expectation of any monetary compensation. I fully understand I am considered an unpaid employee of FSPC, therefore I am not eligible for worker’s compensation in the event of injury or illness that may result from my activities as a FSPC volunteer.

I agree

Social Media
Advocacy
Board Of Directors
Regional Director
Outreach/ Tabling
Presentations
Conference Planning
Special Events
Fundraising
Newsletter
Website / IT
other / unsure

Region 1/(Escambia, Okaloosa, Santa Rosa, Walton)
Region 2/(Bay, Calhoun, Franklin, Gadsden, Gulf Homes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, Washington)
Region 3/(Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, Union)
Region 4/(Baker, Clay, Duval, Nassau, St. Johns)
Region 5/(DeSoto, Pinellas, Sarasota)
Region 6/(Hillsborough, Manatee, Pasco)
Region 7/(Brevard, Orange, Osceola, Seminole)
Region 8/(Charlotte, Collier, Glades, Hendry, Lee)
Region 9/(Palm Beach)
Region10/(Broward)
Region 11/(Dade, Monroe)
Region 12/(Flagler, Volusia)
Region 13/(Citrus, Hernando, Lake, Marion, Sumter)
Region 14/(Hardee, Highlands, Polk)
Region 15/(Indian River, Martin, Okeechobee, St. Lucie)
Virtually
Unsure right now

loss survivor
website
brochure
presentation.
newspaper
community event
FSPC Member
other