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Mid-Florida Foster Parent Association Registration Form

Mission: To strengthen foster/adoptive families through support, training and advocacy with the aim of nurturing child safety, well-being and stability while enhancing teamwork and partnership with the entire community.

Member Information

First Name:*
Last Name:*
Spouse First Name:
Spouse Last Name:
Title & Agency (If Applicable):
County of Residence:*
Address 1:*
Address 2:
City:*
State:*
Zip Code:*
Phone (Home): ( ) -
Phone (Work): ( ) -
Phone (Cell): ( ) -
E-mail:*

Committee Information (you can chose more than one)

Training Fund Raising Newsletter Resources
Public Relations/Advocacy Membership/Election Mentoring Social
Childcare Grievance Other:

Are you interested in charing a committee? If so, which one(s):


Membership Type

Foster Parent Pre-Foster Parent Professional

Are you interested in holding an office? If so, which one(s)? (you can chose more than one)

President Vice-President Secretary Treasurer Comptroller Chairman

* Please note that under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.