New Member Interest Form

Miami-Dade HIV/AIDS Partnership

Get on Board!

Thank you for your interest in volunteering for the Miami-Dade HIV/AIDS Partnership and/or its committees.

The Partnership is the official Ryan White Program Planning Council and Miami-Dade County Advisory Board for HIV prevention and care.

Our members make decisions that improve the lives of more than 8,000 people served by the Ryan White Program in Miami-Dade County.

Partnership members are appointed by the Mayor of Miami-Dade County and committee members can join directly.

Your participation matters! Let's get started!

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* 1. Please complete this contact Information.

Your name *

Name of city where you live *

ZIP Code of city where you live *

Your email

Your phone number *

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* 2. What is the best way to contact you? (check all that apply)

Phone Call

Text Message

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* 3. Are you a permanent resident in Miami-Dade County?

Yes

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* 4. Are you a registered voter in Miami-Dade County?

Yes

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* 5. Can you devote three (3) to five (5) hours each month as a volunteer board member?

Yes

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* 6. How did you hear about this opportunity? Please check all that apply.

Social Media

Ryan White Program Provider

Word of Mouth

Other (please specify)

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* 7. Please provide a brief statement explaining your interest in the Partnership and the HIV planning process, including your background relative to HIV (volunteer, professional, personal) and/or other relevant experience and expertise.

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* 8. Great! We're almost done! Please check all statements that apply to you.

I am a Ryan White Program client.

I work for a Ryan White Program provider organization.

Other (please specify)

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* 9. Next Steps

We will contact you to schedule an interview (via Microsoft Teams), answer questions about membership, and review voucher eligibility.

Please click DONE to submit your application.

Thank you!

New Member Interest Form

Miami-Dade HIV/AIDS Partnership

Question Title

* 1. Please complete this contact Information.

Question Title

* 2. What is the best way to contact you? (check all that apply)

Question Title

* 3. Are you a permanent resident in Miami-Dade County?

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* 4. Are you a registered voter in Miami-Dade County?

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* 5. Can you devote three (3) to five (5) hours each month as a volunteer board member?

Question Title

* 6. How did you hear about this opportunity? Please check all that apply.

Question Title

* 7. Please provide a brief statement explaining your interest in the Partnership and the HIV planning process, including your background relative to HIV (volunteer, professional, personal) and/or other relevant experience and expertise.

Question Title

* 8. Great! We're almost done! Please check all statements that apply to you.

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* 9. Next StepsWe will contact you to schedule an interview (via Microsoft Teams), answer questions about membership, and review voucher eligibility.Please click DONE to submit your application.Thank you!

* 9. Next Steps

We will contact you to schedule an interview (via Microsoft Teams), answer questions about membership, and review voucher eligibility.

Please click DONE to submit your application.

Thank you!