Explorer Program Sign Up Form

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Explorer Program Information Call (954) 828-6979, email: explorers@fortlauderdale.gov or visit: www.flpd.org


Please correct the field(s) marked in red below:

Thank you for your interest in City of Fort Lauderdale's Explorer Program.

Date of Application (MM-DD-YYYY):
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Personal Information:
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Personal Information:
Address:
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Address:
Phone Contact Information (provide at least one contact phone number)
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Phone Contact Information (provide at least one contact phone number)
Email:
What is your gender? (optional)
What is your gender? (optional)
What is your race? (optional)
Age Verification
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Age Verification
Current School Grade
 *
Name of High School Attended
 *
How did you learn about us?
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How did you learn about us?
Please fill out form completely, all answers mandatory unless optional indicated.

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