A Pair to Remember Volunteer Sign Up Form
A Pair to Remember® has made an impact on individuals served by Easterseals Florida. With your support, we change the way the world defines and views disabilities by making profound, positive differences in lives every day through exceptional services, education, outreach, and advocacy.
Support A Pair to Remember® — our community is counting on you! Sign up for one or all shifts – the more helping hands, the better!* All volunteers must be 21 or older.

Please note that those who volunteer 10 hours per month or more are subject to a Level II background screening at the volunteer's expense. If a background check is required, volunteers will be reimbursed for their background check. 

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First Name
Last Name
Phone Number
Emergency Contact Name
Emergency Contact Home Number
Emergency Contact Cell Number
Volunteer Shifts
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If you answered I need to help out during specific hours, please write your availability below.
I certify that all answers given by me are true, accurate and complete. I understand that falsification, misrepresentation, or omission of fact on this application (or on any other accompanying or required documents) will be cause for denial of volunteer opportunities, or dismissal from volunteer work regardless of when or how discovered. I agree to participate in all necessary background screenings.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.
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