APA Florida CPAT Volunteer Sign Up

APA Florida CPAT Application

Thank you for your interest in participating in the Florida Community Planning Assistance Teams (CPAT) program. Conscious of the obligation of planners to the public interest, participation in a CPAT provides a unique opportunity to address serious issues affecting communities across the United States and abroad where planning resources and expertise may otherwise not be available. If you have any questions about the Florida CPAT program, please visit the CPAT website at florida.planning.org/cpat or contact the CPAT representative at connect@floridaplanning.org

Personal Information
Name*

FirstLast AICP, Esq., CNA-A, etc.
Company/Organization/Government Entity*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Mobile Number*

Area CodeNumber
If you have a LinkedIn profile (or other professional online profile), please share the URL.
Are you an APA Florida member?*

YesNo
Are you an AICP member?*

YesNo
Skills and Expertise

Please consider these projects are community-driven, and will include meaningful public participation and team problem solving whenlisting your expert areas.
One to three lines summarizing your main expertise such as policy writing, graphic design, landscape architecture, public speaking, etc.*
Example: "I am a specialist in urban neighborhood revitalization with 15 years experience and a specific focus on affordable housing."
Please upload your resume and/or curriculum vitae (CV).*

Browse Files
Information should include education, training (certifications, credentials, training, special programs), and professional experience. Allowed file types include: pdf, .doc, and .docx. Maximum files size is 8MB. Cancelof
Interests
Statement of Interest.*
Please provide a statement describing your motivation for applying and what you feel you can bring to the team.
Waiver and Agreement
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

WAIVER OF LIABILITY AND RELEASE, INCLUDING A CONSULTING SERVICES AGREEMENT, AS CONDITION OF MY PARTICIPATION IN THE COMMUNITY PLANNING ASSISTANCE TEAM PROGRAM. PLEASE READ THE FOLLOWING CAREFULLY. IF YOU HAVE ANY QUESTIONS, HAVE THEM ANSWERED BEFORE CHECKING THE BOX THAT YOU AGREE.

In consideration of being permitted to participate in a Community Planning Assistance Team (CPAT) initiative, I, in full recognition and appreciation of the dangers and risks inherent in such activities, do hereby waive, release, and forever discharge The American Planning Association, its Institute, The American Institute of Certified Planners, and their officers, agents and employees from and against any and all claims, demands, actions, or causes of actions for costs, expenses or damages to personal property or personal injury or death, which may result from my participation in the CPAT.

I understand and fully acknowledge that my participation in the CPAT is voluntary and I assume full responsibility for any injuries or damages resulting from my participation in the CPAT including responsibility for using reasonable judgment in all phases of my participation in the CPAT and in travel to, from, and within the destination for the CPAT project. I recognize and understand that my participation may encounter hazards, that my participation is solely at my own risk, and that I assume full responsibility for any resulting injuries and damages.

I affirm that I am in good health. I further declare that I am physically fit and capable to participate in the CPAT. I acknowledge that it is the recommendation of both The American Planning Association and The American Institute of Certified Planners that I obtain general medical/health insurance as well as travel, personal property protection, and liability insurance if I am not already covered. I understand that it is my responsibility to notify the appropriate persons on my CPAT and wherever I may be working or traveling of emergency medical information. I also understand that this Waiver of Liability and Release is binding on my heirs, executors, administrators, and assigns, as well as me.

I agree to not seek paid consulting work or any other paid services relating to the CPAT work for one full year starting from the end of the CPAT visit to the destination involved.

I acknowledge that I have read and understand this entire Waiver of Liability and Release, and I agree to be legally bound by it. Moreover, my signature below constitutes my affirmation that I have read, understand and accept all of the terms of the invitation to participate in the CPAT, as set out in the letter to me from The American Planning Association and The American Institute of Certified Planners.

Thank you for your interest in the CPAT program!

We will be in touch when your unique set of skills and experience best match one of our future projects.We also encourage you to spread the word about CPAT - to prospective communities who may need a CPAT's help - and to other professionals who may have an interest in serving as a volunteer team member.If you have any questions in the meantime, please contact the CPAT representative at memberservices@floridaplanning.org.
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APA Florida CPAT Application

Personal Information

Skills and Expertise

Interests

Waiver and Agreement

Thank you for your interest in the CPAT program!