Council Interest Form

Thank you for your interest in applying to the Florida Developmental Disabilities Council. We are currently re-designing our application to better meet the needs of the review committee.
Please complete the below interest form so we have your name and contact information on file. We will reach back out to you once the redesign is complete.
Name(Required)
First Last
Address(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email(Required)
Please select all that apply:(Required)
- Persons with a Developmental Disability
- Family member with a child (under the age of 18) with a developmental disability
- Family member with an adult (over the age of 18) with a developmental disability
- Representative of a not-for-profit organization that provides services to persons with developmental disabilities
- Representative of a non-government agency

Thank you for your interest in applying to the Florida Developmental Disabilities Council. We are currently re-designing our application to better meet the needs of the review committee.