Bright Futures Application Form
(NOTE: Parental Consent Form is required for Volunteers under 18 years of age.)
Have you volunteered with us before?
How did you hear about us (select all that apply)?
Have you spoken to a volunteer site coordinator about the position?
Days available to volunteer (select all that apply) *
Times available to volunteer (select all that apply) *
How many hours can you commit? *
For our record, have you ever been convicted or had adjudication withheld in a criminal offense, or are there any criminal charges pending against you? (Note: A conviction or adjudication withheld will not automatically disqualify you from volunteering with Pinellas County.) *

Acknowledgement Statement *
* Your e-mail address is required to submit this 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 to this address:
Pinellas County Volunteer Services
400 S. Fort Harrison Ave, 1st Floor, Suite 111
 Clearwater, FL 33756