Miami-Dade VOAD Registration

 Monday,
 

Please fill in your Organization's information here
* means Required
*Prefix:
*First Name:
*Last Name:
*Agency/Organization Name:
If your Organization does not appear
in the Agency list above,
please select "-Not Listed-"
and then enter the name here
*Position:
*Street Address:
Address Line 2 or Suite:
*City:
*State:
*Zip/Postal Code:
Divisional EOC: Click Here to view map
Registered with VOAD? Yes No
COOP (Continuity of Operations) Plan in place? Yes No
Please enter all phone numbers in the form ###-###-####
*Office Phone: Ext.
Cell Phone:
*Emergency Alternate Phone:
Fax:
Create a login Username and Password - Your email address will be used as your login Username. You must use it when you login
Password must be longer than 4 and less than 50 characters
*Email Address:
*Password:
*Confirm Password:
(retype same password)
Website:
If you have an Emergency Site (alternate site) in case you cannot work at your primary location, please enter that information here.
Emergency Site Partner Name:
Emergency Site Street Address:
Emergency Site Street Address 2:
Emergency Site City:
Emergency Site State:
Emergency Site Zip/Postal Code:
Emergency Site Office Phone:
Emergency Site Alternative Phone:
Emergency Site Fax:
 
  
If you have any problems using the system, click on the link to email Merline Leonce, the system administrator leoncem@unitedwaymiami.org
Copyright © 2008 Miami-Dade VOAD System designed & developed by: Dan Consulting Services, Inc.