Florida Hands & Voices Membership Application for Families

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Please complete this application for Family membership with Florida Hands & Voices

Email *

Your Full Name *

What is your primary role with the DHH population

DHH Individual

Parent of a DHH child or adult

Other family of a DHH individual

Friend of a DHH individual

Other:

Clear selection

If you are a parent of a child who is Deaf or hard of hearing, please share their name, age, hearing level, and mode(s) of communication:

How did you hear about Florida Hands & Voices?

Telephone Number *

Email Address *

Mailing Address (include city, state and zip code)

What is your preferred method of contact? (Please check all that apply) *

Phone (voice)

Text

Mail

Required

Tell us about yourself (check all that apply) *

I am proficient in ASL and would like to assist in interpreting

I love talking with people and have no problem gaining sponsorships for FLHV

I have connections with venues to have meetings/events

I have experience with non-profit fundraising

I am great with graphic design

I am proficient in Spanish and would like to assist in interpreting

I would like to be involved in supporting other families through Hands & Voices

I am a professional and would like to present on a topic at a H&V virtual gathering

Other:

Required

Which agencies or organizations have you had experience with in the past?

Hands & Voices of Florida

Another Hands & Voices org. outside of Florida

Florida School for the Deaf & the Blind

Early Hearing Detection & Intervention (EHDI)

AG Bell

Listening and Spoken Language Programs/Schools (please specify which one(s) in "other" below)

Florida Educators of the Deaf & Hard of Heading (FEDHH)

Resources, Materials, and Technology Center for the Deaf & Hard of Hearing

FAVI

Option 10

Sertoma

What is your county of residence? *

In your opinion, what are your primary concerns, needs, or challenges for providing support to your DHH family? *

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