Pinellas County Volunteer Form
Volunteer In Pinellas (VIP) Team Member
Application Form

Please complete all applicable fields as appropriate

Your name

Your phone number

Your address
Zip Code
Your e-mail address
Emergency contact name phone
Have you volunteered with us before?
If yes, do you remember when and where?
How did you hear about us?
Are you currently a student?
Is your volunteer experience education related?
Are you currently working?
How soon would you like to start volunteering?
Choose Volunteer Interest Topics  
Is there any expertise or special
experience you'd like to offer?
For our record, have you ever been convicted or
had adjudication withheld in a criminal offense, or
are there any criminal charges now pending against

(NOTE: A conviction or adjudication withheld will not automatically disqualify you from volunteering with Pinellas County.)
Days requested

Time of day requested

What do you hope to gain from this experience?

characters left  

*your e-mail address is required to submit form

E-mail addresses are public records under Florida law and are not exempt from public-records requirements. If you do not want your e-mail address to be subject to being released pursuant to a public-records request, do not send electronic mail to this entity. Instead, contact this office by telephone (727) 464-8477
or in writing, via the United States Postal Service.

Volunteer Services
400 S. Ft. Harrison Ave.
Annex Building, Room 111
Clearwater, Florida 33756