YLD Disaster Legal Services Volunteer Intake

Name*

First Name

Last Name

Florida Bar Number*

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Please list your practice area(s). *

Legal area in which I will render assistance*

General Consumer Help Landlord/Tenant Property Claims Insurance/Injury Claims FEMA Claims/Appeals

Please list any other areas for which you would like to assit.

Please list any additional languages you speak.